[House Hearing, 117 Congress]
[From the U.S. Government Publishing Office]


       SUPPORTING UNDERSERVED COMMUNITIES IN EMERGENCY MANAGEMENT

=======================================================================

                                HEARING

                               BEFORE THE

                            SUBCOMMITTEE ON
                        EMERGENCY PREPAREDNESS,
                         RESPONSE, AND RECOVERY

                                 OF THE

                     COMMITTEE ON HOMELAND SECURITY
                        HOUSE OF REPRESENTATIVES

                    ONE HUNDRED SEVENTEENTH CONGRESS

                             SECOND SESSION
                               __________

                             JULY 19, 2022
                               __________

                           Serial No. 117-66
                               __________

       Printed for the use of the Committee on Homeland Security
                                     

                  [GRAPHIC NOT AVAILABLE IN TIFF FORMAT]

                                     
        Available via the World Wide Web: http://www.govinfo.gov

                              ___________

                    U.S. GOVERNMENT PUBLISHING OFFICE
                    
49-425 PDF                 WASHINGTON : 2022 

                     
                     COMMITTEE ON HOMELAND SECURITY

               Bennie G. Thompson, Mississippi, Chairman
Sheila Jackson Lee, Texas            John Katko, New York
James R. Langevin, Rhode Island      Michael T. McCaul, Texas
Donald M. Payne, Jr., New Jersey     Clay Higgins, Louisiana
J. Luis Correa, California           Michael Guest, Mississippi
Elissa Slotkin, Michigan             Dan Bishop, North Carolina
Emanuel Cleaver, Missouri            Jefferson Van Drew, New Jersey
Al Green, Texas                      Mariannette Miller-Meeks, Iowa
Yvette D. Clarke, New York           Diana Harshbarger, Tennessee
Eric Swalwell, California            Andrew S. Clyde, Georgia
Dina Titus, Nevada                   Carlos A. Gimenez, Florida
Bonnie Watson Coleman, New Jersey    Jake LaTurner, Kansas
Kathleen M. Rice, New York           Peter Meijer, Michigan
Val Butler Demings, Florida          Kat Cammack, Florida
Nanette Diaz Barragan, California    August Pfluger, Texas
Josh Gottheimer, New Jersey          Andrew R. Garbarino, New York
Elaine G. Luria, Virginia            Mayra Flores, Texas
Tom Malinowski, New Jersey
Ritchie Torres, New York
                       Hope Goins, Staff Director
                 Daniel Kroese, Minority Staff Director
                          Natalie Nixon, Clerk
                                 ------                                

     SUBCOMMITTEE ON EMERGENCY PREPAREDNESS, RESPONSE, AND RECOVERY

                Val Butler Demings, Florida, Chairwoman
Sheila Jackson Lee, Texas            Kat Cammack, Florida, Ranking 
Donald M. Payne, Jr., New Jersey         Member
Al Green, Texas                      Clay Higgins, Louisiana
Bonnie Watson Coleman, New Jersey    Mariannette Miller-Meeks, Iowa
Bennie G. Thompson, Mississippi (ex  Andrew R. Garbarino, New York
    officio)                         John Katko, New York (ex officio)
              Lauren McClain, Subcommittee Staff Director
          Diana Bergwin, Minority Subcommittee Staff Director
                Darrin Williams, Jr., Subcommittee Clerk


                            C O N T E N T S

                              ----------                              
                                                                   Page

                               Statements

The Honorable Donald M. Payne, Jr., a Representative in Congress 
  From the State of New Jersey:
  Oral Statement.................................................     1
The Honorable Val Butler Demings, a Representative in Congress 
  From the State of Florida, and Chairwoman, Subcommittee on 
  Emergency Preparedness, Response, and Recovery:
  Prepared Statement.............................................     5
The Honorable Kat Cammack, a Representative in Congress From the 
  State of Florida, and Ranking Member, Subcommittee on Emergency 
  Preparedness, Response, and Recovery:
  Oral Statement.................................................     1
  Prepared Statement.............................................     3
The Honorable Bennie G. Thompson, a Representative in Congress 
  From the State of Mississippi, and Chairman, Committee on 
  Homeland Security:
  Prepared Statement.............................................     6

                               Witnesses

Ms. Denise Bottcher, State Director, AARP Louisiana:
  Oral Statement.................................................     7
  Prepared Statement.............................................     8
Ms. Barbara Ammirati, Senior Advisor, Child Protection, Save The 
  Children:
  Oral Statement.................................................    12
  Prepared Statement.............................................    14
Ms. Marcie Roth, Executive Director and Chief Executive Officer, 
  World Institute on Disability:
  Oral Statement.................................................    17
  Prepared Statement.............................................    19
Mr. Antoine B. Richards, Chief of Staff, Institute for Diversity 
  and Inclusion in Emergency Management:
  Oral Statement.................................................    32
  Prepared Statement.............................................    34
Mr. Preston Bowlin, Emergency Management Director, Emergency 
  Management Division, Marion County:
  Oral Statement.................................................    37
  Prepared Statement.............................................    39

 
       SUPPORTING UNDERSERVED COMMUNITIES IN EMERGENCY MANAGEMENT

                              ----------                              


                         Tuesday, July 19, 2022

             U.S. House of Representatives,
                    Committee on Homeland Security,
                   Subcommittee on Emergency Preparedness, 
                                    Response, and Recovery,
                                                    Washington, DC.
    The subcommittee met, pursuant to notice, at 9:05 a.m., in 
room 310, Cannon House Office Building, Hon. Donald M. Payne, 
Jr. [Acting Chairman of the Subcommittee] presiding.
    Present: Representatives Payne, Green, Watson Coleman, and 
Cammack.
    Mr. Payne. The Subcommittee on Emergency Preparedness, 
Response, and Recovery will come to order. Without objection, 
the Chair is authorized to declare the subcommittee in recess 
at any point.
    Good morning. We are here to discuss how underserved 
communities are treated during disasters and learn what more 
the Federal Government can do to protect these communities. I 
am pleased to be filling in as Chairman today for today's 
hearing on behalf of my distinguished colleague, Congresswoman 
Val Demings.
    When I served as Chairman and Ranking Member of this 
subcommittee, today's hearing was one of the topics that I 
closely followed and worked to address. I applaud Congresswoman 
Demings' dedication to the subject at hand and I am pleased to 
see her continue the fight for helping those who are 
underserved or vulnerable during disasters.
    During my time in office, improving the lives of children 
has been a priority. In 2017, I introduced the Homeland 
Security Act for Children, a bill to ensure the Department of 
Homeland Security considered and incorporated the unique needs 
of children throughout its policies and programs. After years 
of pursuing enactment of the bill, I am very pleased to say 
that on June 6, 2022, the Homeland Security for Children Act 
was signed into law by President Biden.
    I look forward to discussing with the witnesses this new 
law and how Congress can continue to push for changes that will 
help those who need the most help during emergencies. The Chair 
now recognizes the Ranking Member of the Emergency 
Preparedness, Response, and Recovery Subcommittee, the 
gentlewoman from Florida, Mrs. Cammack, for an opening 
statement.
    Mrs. Cammack. Well, thank you, Mr. Chairman, and thank you 
to our witnesses who are here with us in person today, as well 
as those joining us virtually. The disaster recovery process is 
best described by the National Disaster Recovery Framework as 
``a sequence of interdependent and often concurrent activities 
that progressively advance a community toward its planned 
recovery outcomes.'' Oftentimes, much of the discussions 
surrounding disaster recovery efforts is centered around 
improvements that should be made at the Federal level. However, 
close coordination between State, Federal, local, Tribal, and 
territorial partners is necessary for a successful recovery 
process.
    As a Floridian, I think we can speak to this first-hand. 
That is why I am so grateful that the Emergency Management 
Director for my home county, Marion County, Mr. Preston Bowlin, 
is able to join us here today and testify. I know his 
experience in his current role, as well as his previous 
experience in the fire service, and of course, you all know I 
am partial as a fire wife, but as a law enforcement officer, 
will provide some unique insight into how we can provide better 
support to this historically underserved community before, 
during, and after disasters.
    The significant increase in the number, severity, and types 
of disasters that FEMA has been called on to respond to in 
recent years only highlights the vital importance of having 
effective coordination between emergency managers at all levels 
of government. As we heard from Administrator Criswell during 
our last hearing, FEMA is currently managing more than 300 
disasters, of which 44 disasters declared so far this year, and 
the on-going response to the COVID-19 pandemic continues.
    To respond to these disasters, FEMA and other Federal 
agencies provide billions in response and recovery aid to 
individuals and communities across the country. FEMA provides 
assistance through a variety of programs through the individual 
assistance and public assistances programs, the National Flood 
Insurance program, and the Hazard Mitigation Grant program.
    Now, while I applaud the progress that FEMA has made in 
recent years to identify and address the barriers to recovery 
aid, I think everyone here today can agree that there is a lot 
more work to be done. Underserved communities in emergency 
management can include those living in low-income 
neighborhoods, communities of color, people with disabilities, 
older adults, children, those with language barriers, and those 
living in rural and isolated areas. As a district that 
encompasses pretty much every one of those categories, I can 
say this issue couldn't be more important.
    Today, I would like to talk briefly about two underserved 
populations, older adults and those living in rural 
communities. During my time in Congress thus far, I have worked 
hard to address the unique challenges facing these populations 
within my district. As the last few years have shown us, a 
critical aspect of homeland security is ensuring that our 
Federal, State, local, Tribal, and territorial governments have 
the proper plans in place to address significant public health 
responses.
    Having these types of plans in place are especially 
important to help protect the senior population in our 
communities. I heard from many of my constituents that 
navigating on-line registrations, scheduling systems for 
vaccine appointments have proven to be a major barrier for many 
of our seniors in our community. There certainly is a 
generational divide when it comes to this very issue. But also, 
living in an area where rural broadband is not readily 
accessible, also another major challenge.
    In response to these concerns, I travelled to all six of my 
counties in Florida's 3rd Congressional District to check in 
with health leaders and emergency managers at vaccination 
sites. I am also thankful that Governor Ron DeSantis and his 
team worked hard to put our seniors first, ensuring the more 
vulnerable citizens amongst us received the COVID vaccine in a 
timely manner when and if they wanted it.
    In addition to working to address the challenges facing 
older adults, I have also been a strong advocate for those 
living in our rural communities. About 60 million, or 1 in 5, 
Americans live in rural areas. Rural communities including 
parts of my district face many of the same challenges as larger 
more urban communities. However, as discussed in our previous 
hearings, these rural communities face additional challenges 
brought on by a lack of available resources, funding, and 
connectivity.
    So, in closing, I would like to thank all of our witnesses 
for participating in this hearing today. I look forward to 
hearing your thoughts on how we can all work together to 
improve outcomes for all disaster survivors. With that, Mr. 
Chairman, I yield back.
    [The statement of Ranking Member Cammack follows:]
                Statement of Ranking Member Kat Cammack
                             July 19, 2022
    Thank you, Chairwoman Demings.
    The disaster recovery process is best described by the National 
Disaster Recovery Framework as, ``a sequence of interdependent and 
often concurrent activities that progressively advance a community 
toward its planned recovery outcomes.''
    Oftentimes, much of the discussion surrounding disaster recovery 
efforts is centered around improvements that should be made at the 
Federal level. However, close coordination between Federal, State, 
local, Tribal, and territorial partners is necessary for a successful 
recovery process.
    That is why, I am so grateful that the Emergency Management 
Director for Marion County, Preston Bowlin, is able to testify here 
today.
    I know his experience in his current role, as well as his previous 
experience in the fire service and as a law enforcement officer, will 
provide some unique insight into how we can provide better support to 
historically underserved communities before, during, and after 
disasters.
    The significant increase in the number, severity, and types of 
disasters that FEMA has been called on to respond to in recent years 
only highlights the vital importance of having effective coordination 
between emergency managers at all levels of government.
    As we heard from Administrator Criswell during our last hearing, 
FEMA is currently managing more than 300 disasters--which includes 44 
disasters declared so far this year and the on-going response to the 
COVID-19 pandemic.
    To respond to these disasters, FEMA and other Federal agencies 
provide billions in response and recovery aid to individuals and 
communities across the country.
    FEMA provides assists through a variety of programs including the 
Individual Assistance and Public Assistance programs, the National 
Flood Insurance Program, and the Hazard Mitigation Grant Program.
    While I applaud the progress that FEMA has made in recent years to 
identify and address barriers to recovery aid, I think everyone here 
today can agree that there is more work left to be done.
    Underserved communities in emergency management can include those 
living in low-income neighborhoods, communities of color, people with 
disabilities, older adults, children, those with language barriers, and 
those living in rural and isolated areas.
    Today I would like to briefly talk about two underserved 
populations: older adults and those living in rural communities. During 
my time thus far in Congress, I have worked hard to address the unique 
challenges facing these populations within my district.
    As the last few years have shown us, a critical aspect of homeland 
security is ensuring that our Federal, State, local, Tribal, and 
territorial governments have the proper plans in place to address 
significant public health responses.
    Having these types of plans in place are especially important to 
help protect the senior citizens in our communities. I heard from many 
of my constituents that navigating the on-line registration and 
scheduling systems for vaccine appointments had proven to be a major 
barrier for many seniors in our community. In response to these 
concerns, I visited all 6 counties in Florida's 3rd to check in with 
health leaders at vaccination sites.
    I am also thankful that Gov. Ron DeSantis and his team worked hard 
to put our seniors first, ensuring the more vulnerable citizens among 
us received the COVID vaccine in a timely manner when and if they 
wanted it.
    In addition to working to address the challenges facing older 
adults, I have also been a strong advocate for those living in rural 
communities.
    About 60 million or 1 in 5 Americans live in rural areas. Rural 
communities, including parts of my district, face many of the same 
challenges as larger, more urban communities. However, as we have 
discussed in previous hearings, these rural communities also face 
additional challenges brought on by lack of available resources and 
funding.
    In fact, a report published by GAO last year discussed the barriers 
many disaster survivors face in accessing assistance programs and 
resources to support their recovery efforts. The report highlighted 
that limited internet access as well as a lack of financial resources 
and available staff can all cause reduced access to resources for 
individuals living in rural and isolated areas.
    In closing, I'd like to thank all of our witness for participating 
in this hearing today and I look forward to hearing your thoughts on 
how we can work together to improve outcomes for all disaster 
survivors.
    With that, I yield back.

    Mr. Payne. Thank you. I now welcome our panel of witnesses. 
Our first witness is Denise Bottcher. She is the State director 
of the AARP in Louisiana. Ms. Bottcher leads a five-member team 
in Baton Rouge and New Orleans.
    Our second witness is Ms. Barbara Ammirati. Ms. Ammirati is 
the senior advisor, child protection for Save the Children. Ms. 
Ammirati led the response and recovery programs across five 
Save the Children disaster programs, including Puerto Rico, 
North Carolina, and Florida in 2017 and 2018.
    Our third witness is Marcie Roth. Ms. Roth is the executive 
director and chief executive officer for World Institute on 
Disability. From 2009 to 2017, Ms. Roth served as the senior 
advisor to the administration of the Federal Emergency 
Management Agency, where she established and directed the 
Office of Disability, Integration, and Coordination.
    Our fourth witness is Antoine B. Richards, who is the chief 
of staff for the Institute for Diversity and Inclusion in 
Emergency Management. Mr. Richards' experience includes almost 
a decade of work in the health care and emergency management 
sectors.
    I will now recognize the gentlewoman from Florida, Mrs. 
Cammack, to introduce our fifth and final witness.
    Mrs. Cammack. Thank you, Mr. Chairman. It is a great honor 
and privilege to introduce a good friend of mine, Emergency 
Management Director Preston Bowlin, who has served with the 
Marion County Sheriff's Office in Ocala and has been a member 
of our community as a first responder in that capacity for over 
32 years. Now, he has been an instructor for the last 25 years 
for various EMS, fire, and law enforcement courses. For the 
last 15, has been facilitating tactical medical training to law 
enforcement, EMS, and military agencies from around the United 
States and the world.
    Director Bowlin previously served as an EMS advisor to the 
chief financial officer for the State of Florida, who is also 
the State marshal, is how it kind-of works out in Florida, and 
is a retired member of the Urban Search and Rescue Florida Task 
Force Team 8. Team 8 also was one of the responding teams to 
the Surfside building collapse in South Florida, tragically 
last year.
    Now, this is just a brief summary of Director Bowlin's many 
accomplishments. But based on his vast experience and insights 
that he will be able to provide today, I know that his 
testimony will be invaluable. In fact, just over the weekend, 
he called me as another tornado ripped through our district. It 
was late at 11 at night and he was out boots on the ground. So, 
I know as someone who has been there front and center, he is 
going to have tremendous insight into this issue. So, I thank 
the director for his continued service to our community and I 
am so pleased that he is able to join us here in Washington, DC 
to testify before this committee.
    Mr. Payne. Thank you, gentlelady. Without objection, the 
witnesses' full statements will be inserted in the record. 
Additional Member statements may also be submitted for the 
record.
    [The statements of Chairwoman Demings and Chairman Thompson 
follow:]
                  Statement of Chairwoman Val Demings
                             July 19, 2022
    We are here to discuss communities that are most at-risk during 
disasters and struggle to recover properly from their effects. 
Disasters impact everyone, but not everyone experiences disasters in 
the same way. In Florida, we are no stranger to disaster. In recent 
years, we have weathered Hurricanes Michael and Irma. This year, we've 
seen floods in the South and tornadoes in the North.
    We are now in another hurricane season that has been predicted to 
be above average, which is why it is so important that we address the 
needs of our most underserved communities. We know that some 
individuals are more impacted than others throughout the life span of a 
disaster, from preparation to recovery. Yet all too often vulnerable 
communities are pushed to the sidelines, ignored, and even 
discriminated against, during these crises. Communities with 
disabilities regularly see their civil rights sidelined during 
emergencies. Too often shelters and emergency communications are 
inaccessible. Children's unique needs are also often overlooked, 
leading to insufficient medical care and a lack of services tailored to 
children.
    As a mother and a grandmother, I find it very troubling that 
children's needs are often not prioritized during disaster. Children 
hold our future and protecting them, especially when they cannot 
protect themselves, is critical. I want to take a minute to 
congratulate my friend, the gentlemen from New Jersey, Mr. Payne on his 
legislation, the Homeland Security for Children Act, which President 
Joe Biden signed into law last month. This legislation will take 
important steps to improving the Department of Homeland Security's 
ability to meet the needs of children.
    Age in and of itself does not determine vulnerability to disasters. 
However, older individuals also suffer disproportionately during 
disasters. Forty percent of the casualties after Katrina were 71 years 
old or older. Twenty-one percent of Floridians are 65 and older. We 
recognize the valuable contributions they make to our community and the 
need to help them prepare for and recover from disasters. As we have 
established in previous hearings on equity, low-income and minority 
communities often struggle to access support from preparedness, 
recovery, and mitigation funding, hurting their ability to cope with 
disasters.
    I am proud to have partnered with Chairman Thompson on the FEMA 
Equity Act to address these flaws in our Federal emergency management 
system. This legislation is incredibly important because it reinforces 
the concept that all Americans deserve to be supported during crises--
regardless, of where they come from, their age, ability, race, or 
ethnicity. Sadly, we know that all too often money is a barrier to 
individuals and families preparing for and withstanding a disaster. 
Access to resources such as a car to evacuate or the internet to get 
proper alerts can all be key factors in surviving a storm.
    Growing up, I was the youngest of seven, the daughter of a maid and 
a janitor. We grew up poor. We experienced hard times, just like many 
working-class families in Florida are facing trying times now. In times 
like these, we, as a Nation, have a responsibility to ensure that 
everyone can weather storms, and that no one is left behind, regardless 
of where they live, abilities, or whether they are rich or poor or are 
younger or older.
    The Federal Emergency Management Agency has begun to expand support 
for underserved communities, including making equity a core tenant of 
its strategic plan. FEMA's work on equity includes taking social 
vulnerability into account when investing in mitigation projects to 
ensure that we are prepared to withstand shocks and recover more 
easily. This is a good start, but there is still more that must be 
done.
                                 ______
                                 
                Statement of Chairman Bennie G. Thompson
                             July 19, 2022
    It is a fact that disasters do not impact all people equally. 
Underserved communities, including older adults, communities of color, 
individuals with access and functional needs, children, and low-income 
individuals are more susceptible to the risks associated with disasters 
and are often overlooked during emergencies, making it significantly 
more difficult for them to recover. We have seen time and time again 
when underserved communities fare considerably worse after disasters. 
Hurricanes Katrina, Harvey, Maria, and Ida are prime examples of how 
disasters can disproportionately impact underserved populations.
    In 2005, Hurricane Katrina hit some of the poorest States, 
including Mississippi. I saw first-hand how Katrina devastated my 
community and how difficult it was for underserved communities to 
recover. The storm left the poorest even more vulnerable and uncovered 
long-standing inequities. In 2017, Hurricane Maria left nearly 3,000 
people dead in Puerto Rico, most of whom were elderly and low-income 
individuals. More needs to be done for underserved communities, 
especially since we keep seeing the pattern of people left without the 
assistance they need.
    Over the years, the Committee on Homeland Security has worked to 
address the needs of underserved communities in emergencies. I would 
like to commend my dear friend, Representative Payne, for his bill, the 
Homeland Security for Children Act, being signed into law on June 6th. 
This new law is a major step toward ensuring children's needs are 
considered during disasters. Looking ahead, extreme weather events are 
increasing in frequency and intensity, and vulnerable communities are 
the ones suffering and will continue to suffer unless we improve 
emergency preparedness and develop resilient infrastructure within 
underserved communities.
    The climate crisis is, unfortunately, our new normal, and we must 
invest in underserved communities and provide mitigation resources to 
prevent more loss of life. The Biden administration has taken several 
steps to address underserved populations including adjusting 
documentation requirements for Federal disaster assistance in response 
to long-standing challenges. Additionally, the Biden administration has 
made it their central goal to address the needs of different 
communities by ensuring that FEMA and other agencies incorporate equity 
into their program and policies. Nonetheless, more can and must be 
done.
    After seeing several gaps in the Federal Government's response to 
disasters and how it distributes assistance, I, along with Chairwoman 
Demings and Senator Elizabeth Warren, introduced the FEMA Equity Act. 
This legislation will improve data collection at FEMA and direct the 
agency to integrate equity criteria throughout its programming. It will 
also empower local governments affected by natural disasters to request 
an emergency or major disaster declaration when requests are not 
submitted by the State. I look forward to hearing from our witnesses 
today about the challenges underserved communities face in disasters 
and how Congress could help to better support them.

    Mr. Payne. I now ask each witness to summarize their 
statements for 5 minutes beginning with Ms. Denise Bottcher.

  STATEMENT OF DENISE BOTTCHER, STATE DIRECTOR, AARP LOUISIANA

    Ms. Bottcher. Good morning, Chairman Payne and Ranking 
Member Cammack. I am Denise Bottcher, State director for AARP 
Louisiana. AARP welcomes this opportunity to address the impact 
of disasters on our Nation's older adults and to recommend 
steps that can be taken to better protect them and support 
their recovery.
    Tragically, older adults represent the majority of those 
who die in disasters and a disproportionate share of victims 
are racial and ethnic minorities. AARP works Nation-wide to 
protect the health and safety of older adults through 
education, advocacy, and volunteer service. Many of our State 
offices have been engaged in disaster preparedness education 
and recovery for years, fighting for stronger nursing home 
emergency preparedness, more reliable energy in the face of 
blackouts, and more effective communication systems to inform 
older adults.
    For these reasons and more, it really became clear that 
part of the solution lies in crafting stronger relationships 
with those who respond to disasters and with those who work 
with older adults. To that end, AARP and FEMA have established 
a long-term strategic partnership to advance accessible, safe, 
and livable communities for people of all ages. Last week, we 
released a publication, the AARP Disaster Resilience Toolkit. 
It provides guidance to local and State leaders on how to 
create a more resilient future that puts the needs of older 
adults at the forefront. Then FEMA's Guide to Expanding 
Mitigation, making the connection to older adults, discusses 
how natural hazards affect older adults and provides guidance 
on how to reduce those risks.
    Extreme weather events can shut down the supports and 
services a community depends on to survive and recover. Without 
food, water, medications, and the ability to communicate and 
share information, older adults can experience devastating 
impacts on their physical and mental health. Sustained power 
outages can quickly turn into a life-or-death situation. In 
Louisiana, Hurricane Ida's wind and water weren't the greatest 
threats to older adults. It was the heat. After 4 days of 
sweltering and extreme heat and humidity, 8 senior housing 
complexes were evacuated. Residents reported that they felt 
like they were trapped in an oven several stories up with no 
way out. They were abandoned and some of them died.
    The city of New Orleans responded swiftly and worked with 
multiple organizations, including AARP Louisiana, to pass an 
ordinance that requires a license to operate a senior housing 
facility and requires building managers to maintain both a 
resident census and then provide on-site personnel during 
states of emergency. The ordinance went an extra step and now 
requires senior housing complexes to coordinate emergency and 
evacuation planning with the city. Understanding the unique 
needs of older adults, maintaining a state of preparedness, and 
planning for emergencies and evacuations would have saved 
lives.
    Disasters also endanger the financial security of older 
homeowners, many of whom rely on the equity in their home as 
their largest source of savings. As recovery begins, older 
adults are often targeted by fly-by-night contractors. They 
also face challenges navigating the often complex Federal 
recovery assets that are largely on-line due to the lack of 
access to high-speed internet and the wide digital literacy gap 
that persists among older adults. We should not forget the old-
school ways of getting information and resources into 
residents' hands. Just having boots on the ground, going door-
to-door, and meeting people where they are helps ensure more 
equitable recovery.
    Within each disaster come learning opportunities and I 
would like to share some of those lessons we have learned 
following these disasters and informed by our partnership with 
FEMA. First, we have learned that it is essential to make the 
right connections and build relationships across the fields of 
emergency managers and advocates for older adults. Second, it 
is critical to identify where older adults live and how best to 
communicate with them given the digital literacy gap. It is 
also essential to seek and include diverse perspectives in the 
process of planning for disaster response and recovery. Fourth, 
leaders must be mindful of response and relocation risks. The 
disruption associated with displacement, whether short- or 
long-term, can accelerate cognitive decline and compromise 
physical health. Finally, we must employ community-wide 
infrastructure strategies. This includes expanding broadband, 
access, and education, strengthening the range of 
transportation options, and protecting the areas at greatest 
risk from future disasters.
    In closing, thank you for the opportunity to testify before 
you today on this vital issue. Older adults endure the brunt of 
damage from disaster events and their unique needs must be 
addressed in National emergency preparedness, response, and 
recovery policies, plans, and programs. We look forward to 
working with you.
    [The prepared statement of Ms. Bottcher follows:]
                 Prepared Statement of Denise Bottcher
                             July 19, 2022
    Good morning, Chairman Demings, Ranking Member Cammack, and Members 
of the House Subcommittee on Emergency Preparedness, Response, and 
Recovery. I am Denise Bottcher, State director for AARP Louisiana. AARP 
welcomes this opportunity to address the impact of increasingly 
frequent disasters on our Nation's older adults and to recommend steps 
that can be taken to avert or mitigate the harm and to aid recovery.
                  impact of disasters on older adults
    Tragically, older adults represent the majority of those who perish 
in disasters. Such was the case in Hurricane Katrina in 2005, where 
people age 75 and older accounted for over half of lives lost--despite 
being only 6 percent of the New Orleans population. Similarly, when 
Hurricane Sandy hit the New York Tri-State area several years later, 
nearly half of the deceased were estimated to be 65 or older. Even 
higher shares of death among older adults have occurred in more recent 
disasters. Of those who died in the 2018 Camp Fire in California, 85 
percent were age 60 or older. And in last year's Texas winter storm, 60 
percent of deaths were persons over age 60. Further, due to systemic 
societal inequities, a disproportionate share of older disaster victims 
are racial and ethnic minorities.
    These tragic outcomes are not inevitable. Agencies and communities 
that possess a clear understanding of the unique needs of older adults 
in disaster events, including an understanding of the impact of extreme 
weather on the health and well-being of older adults, are better 
equipped to keep them safe.
    For several years, AARP has worked through our State offices and 
our Nation-wide channels both to promote a better understanding of 
older adults and their needs related to disasters and to educate older 
adults and their families in the hopes of creating truly age-friendly, 
resilient communities.
    Toward this end, we recently released a publication that provides 
guidance to local and State leaders on how to create a more resilient 
future that puts the needs of older adults at the forefront. The AARP 
Disaster Resilience Tool Kit, developed together with the Federal 
Emergency Management Agency (FEMA), explores the unique needs of older 
adults when disaster strikes, including the impacts of extreme heat. 
Due to their often-weakened cardiovascular systems, a lower ability to 
reduce body temperature through sweat, and complications arising from 
preexisting medical conditions, the impact of heat on older adults is 
particularly acute. Furthermore, extreme heat poses greater challenges 
for those who live on fixed incomes and are unable to easily afford to 
cool their homes or who lack transportation to cooling centers. Heat 
impacts are further exacerbated for people whose neighborhood lacks the 
cooling effect of trees, who live in older manufactured homes, who are 
socially disconnected from neighbors or caregivers who can monitor 
their condition, or who are unhoused.
    Other types of disasters and public health emergencies are no less 
dangerous. Sadly, flooding threatens coastal areas where seniors have 
chosen to live or are being cared for. In fact, coastal regions saw an 
89 percent increase in the number of residents age 65 or older between 
1970 and 2010. One assessment predicts that two out of every three of 
beds in Florida nursing homes and assisted living facilities are 
located in areas that will likely experience occasional or frequent 
flooding over the next three decades.\1\
---------------------------------------------------------------------------
    \1\ AARP Disaster Resilience Tool Kit, July 2022, p. 10. https://
www.aarp.org/livable-communities/tool-kits-resources/info-2022/aarp-
disaster-resilience-tool-kit-download.html.
---------------------------------------------------------------------------
    As the COVID-19 pandemic swept the Nation, its impact has been 
especially deadly for older adults, particularly residents of nursing 
homes and other long-term care facilities. Far too often, State and 
local emergency planning drills and efforts overlook older adults and 
people with disabilities who reside in nursing homes or other 
facilities, or who receive home and community-based services, as well 
as the staff who care for them, and their family caregivers. A failure 
to include these individuals in advance planning, communications, and 
drills costs lives. Over the years, AARP has provided comments on 
Centers for Medicare & Medicaid Services' proposed regulations 
regarding emergency preparedness and nursing homes participating in 
Medicare and Medicaid.
    Of course, the vast majority of older adults do not live in 
congregate facilities. Less than 4 percent of older adults live in 
nursing homes or assisted living facilities. Many millions more live 
independently in their homes, often alone. Individuals who remain at 
home through disaster events, either by choice or under duress, 
confront the risks of power outages, the shortage of food and 
prescription medicines, and interrupted medical care or in-home 
caregiving support. Many older adults who might want to evacuate out of 
harm's way are impeded from doing so by a variety of circumstances, 
such as a lack of transportation, savings, and access to information. 
Others may be reluctant to retreat to cooling centers or shelters 
because of a reliance on in-home medical equipment, in-home care, or 
even pets. Once the immediate danger has passed, older adults continue 
to face threats as targets of fraudulent rebuilding schemes in the 
chaos of the recovery phase. They also face challenges in accessing 
Federal relief due to a lack of information, technology, and broadband.
    Disasters also endanger the financial security of older homeowners, 
many of whom rely upon the equity in their home as their largest source 
of savings. This is particularly true for those in high-risk areas, who 
frequently cannot afford increased insurance costs on their fixed 
incomes--if insurance is even available to them. The cost of rebuilding 
and recovery may be out of reach for those who lack adequate savings, 
including the 46 percent of people over 50 who have no emergency 
savings.\2\
---------------------------------------------------------------------------
    \2\ AARP Public Policy Institute, ``Unlocking the Potential of 
Emergency Savings'' on-line article, October 19, 2020. https://
www.aarp.org/ppi/info-2019/unlocking-the-potential-of-emergency-
savings-accounts.html.
---------------------------------------------------------------------------
                             aarp responses
    AARP is dedicated to supporting older adults' well-being. We have 
contributed to disaster relief efforts through our AARP Foundation 
since 2010, and many of our 53 State offices have been at the forefront 
of preparedness and education efforts over the years. For example, the 
AARP New York State office has helped amplify disaster response 
messaging to reach older New Yorkers. The office also coordinated 
disaster philanthropy after Hurricane Sandy, and again most recently 
after the severe flooding in Brooklyn and the Bronx as a result of 
Hurricane Ida. In Florida and Louisiana, disaster preparedness is now a 
year-round topic of conversation and education among AARP members. 
Through public service announcements and targeted media, our State 
offices work diligently to reach our members to encourage preparedness, 
combat contractor fraud, and promote home generator safety. 
Regrettably, the Government Accountability Office found in 2019 that 
many older individuals and persons with disabilities may have faced 
challenges registering for and receiving assistance from FEMA and its 
non-Federal partners (such as State, territorial, and local emergency 
managers).\3\ Following a disaster, and in close coordination with 
emergency responders, AARP works to connect older adults to recovery 
resources.
---------------------------------------------------------------------------
    \3\ U.S. Government Accountability Office, ``Disaster Assistance: 
FEMA Action Needed to Better Support Individuals Who Are Older or Have 
Disabilities,'' May 2019.
---------------------------------------------------------------------------
    In North Carolina, AARP used our Hub Dialer volunteer call program 
to call veterans in the State to offer a free Emergency Go Bag. And 
AARP regularly leads programming through Rural Free Delivery (RFD) TV 
to educate members in remote and rural areas about how to better 
prepare for disasters.\4\
---------------------------------------------------------------------------
    \4\ AARP, ``Preparing for Any Disaster'' September 2021, https://
states.aarp.org/preparing-for-any-emergency-september-2021.
---------------------------------------------------------------------------
    In recent years, however, more AARP State offices have seen the 
need to engage in mitigation and resilience efforts, noting the 
disproportionate impacts of disasters on older adults. For example, 
AARP Texas fought for stronger protections for medically needy Texans 
dependent on electricity following Winter Storm Uri in 2021. Uri killed 
146 Texans over 60 years of age, most of them from hypothermia. The 
protections include notification ahead of losing power, as well as 
requirements that backup power generation be in place for all long-term 
care facilities. Similarly, after 12 South Florida nursing home 
residents died in 2017 due to a prolonged power outage after Hurricane 
Irma, AARP Florida pushed for enforcement of a State law requiring 
nursing homes and assisted living facilities to have emergency back-up 
power.
                        the louisiana experience
    Turning to my home State, as we approach the height of hurricane 
season--mid-August through September--AARP Louisiana is ramping up its 
education and outreach to older adults.
    My team and I recently returned from a trip to Southwest Louisiana 
where we met with pastors to discuss their communities' recovery from 
the devastating hurricane season of 2020. We learned that rebuilding 
was slow--particularly for those on fixed incomes with few financial 
resources. For older adults, navigating the often complex Federal and 
State recovery assets is a daunting task made more difficult when 
offered virtually or on-line. The digital literacy gap for older adults 
is wide. That is why my team is working with LACONNECT--the Governor's 
Office of Broadband and Connectivity--to explore solutions to high-
speed access and digital equity in times of disaster. But while we are 
working to bring solutions to the table, we should not forget the ``old 
school'' ways of getting information and resources into residents' 
hands. Having boots on the ground--going door to door--and meeting 
people where they are helps ensure a more equitable recovery.
    Following the tragic deaths of nursing home residents during 
Hurricane Ida, AARP Louisiana not only called on Federal and State 
authorities to conduct a thorough and transparent investigation into 
what transpired, but also worked with the Louisiana Department of 
Health and other stakeholders to strengthen emergency planning for all 
nursing homes in the State--not just for those on the coast. 
Legislation passed just a few months ago requires all nursing homes in 
Louisiana to have back-up power and it calls for greater collaboration 
with emergency preparedness authorities. It also gives the Department 
of Health increased responsibility to not just to review the plans, but 
to approve them.
    Greater collaboration and establishing clear lines of communication 
in advance of a disaster is key to protecting the health and safety of 
vulnerable populations. Hurricane Ida's wind and water weren't the 
greatest threat to older adults. It was the heat. After 4 days of 
sweltering in extreme heat and humidity, and with several deaths, 8 
senior housing complexes were evacuated. Residents reported that they 
were trapped in an oven--several stories up with no way out due to 
physical limitations. Residents had been abandoned. The city of New 
Orleans responded swiftly and worked with multiple organizations, 
including AARP, to pass an ordinance that requires a license to operate 
a housing facility, and requires building managers to both maintain a 
resident census that details health needs and provide on-site personnel 
during states of emergency. The ordinance went an extra step and now 
requires senior housing complexes to coordinate emergency and 
evacuation planning with the city.
              lessons learned from collaboration with fema
    For the above reasons and more, it became clear that part of the 
solution lies in crafting stronger relationships with those who respond 
to disasters and those who care for older adults. To that end, AARP and 
FEMA have established a long-term, strategic partnership to advance 
accessible, safe, and livable communities for people of all ages, most 
recently materializing in the collaboration to produce two 
complementary and co-branded documents focused on disaster planning, 
mitigation, and risk reduction. FEMA's Guide to Expanding Mitigation: 
Making the Connection to Older Adults discusses how natural hazards 
affect older adults and provides tips to reduce that risk. The guide is 
intended for emergency managers as well as State, local, Tribal, and 
territorial officials, planners, and other community stakeholders that 
serve or advocate for older adults. In addition, AARP's Disaster 
Resilience Tool Kit helps local community leaders develop strategies to 
reduce risk and the impacts of disasters on older adults.
    While we expect the resources to be of great value in helping 
emergency managers, disaster recovery experts, older adult advocates 
and caregivers, and local and State leaders to establish better 
protocols to reduce risk for older adults, we also have already gained 
important lessons from the collaboration that are worth sharing with 
this committee.
    We have learned that it is essential to make the right connections 
and build relationships across the fields of emergency managers and 
advocates for older adults--particularly given that they tend to 
operate with a distinct set of terminology and language that can impede 
mutual understanding. This committee knows the adage that the worst 
time to exchange business cards is at the site of a disaster--
relationships between those responsible for disaster preparedness and 
recovery and those who advocate for older adults are essential to have 
in place well before disaster strikes.
    We have learned that it is critical to identify where older adults 
are and how to reach them. Too often, people assume that if you have a 
plan for evacuating nursing homes, you have checked the box for older 
people. That's a deadly assumption. Most older adults live in their own 
homes and apartments, sometimes alone, and too often isolated. Special 
needs registries, that are voluntary and have privacy protections for 
information provided, can help provide better support for people who 
need it, and more precise information for first responders. In the wake 
of past disasters, States from Florida to Oregon have developed special 
needs registries to ensure better support for people who need it, and 
more precise information for first responders. More States should 
develop these kinds of tools to help localities get assistance to 
people with special needs. It is also critical that localities know 
which communications means are most effective, including low-tech 
options, to ensure that people get timely updates and news.
    We have learned that it is essential to seek and include diverse 
perspectives in the process of planning for long-term development as 
much as it is for disaster response and recovery. Only by hearing 
directly from those who come from diverse racial, ethnic, cultural, and 
religious traditions, and who represent different education and income 
levels, can a community truly plan for a resilient future.
    In addition, we have learned that communities must be mindful of 
response and relocation risks. Not only can relocation be infeasible 
for some due to the inability to drive, secure temporary housing, or 
the unwillingness to leave pets, but relocation is inherently tied to 
the need to remain connected to essential in-home medical equipment, or 
nearby caregivers. Many older adults can meet their medical needs in 
non-institutional settings with equipment such as ventilators, oxygen 
concentrators, and insulin pumps. Travelling with this equipment may be 
challenging both from a logistical standpoint and for the persons using 
the equipment. And for some who do relocate, the disruption associated 
with displacement--whether short- or long-term--can accelerate 
cognitive decline and compromise their physical health when medical 
care is interrupted.
    Finally, we have learned that in order to better reduce the risk 
exposure for older adults, we must employ community-wide infrastructure 
strategies, including those that expand broadband access and education 
to all households, strengthen the range of transportation choices 
available to residents, and better protect the areas at greatest risk 
from future disasters, including those subject to repeated flooding, 
wildfires, or persistent drought conditions.
                            recommendations
    The challenges to preserving the safety and well-being of older 
adults when disasters occur are great. The solutions must be multi-
pronged. AARP urges the following specific actions:
   The Federal Government should take a leadership role with 
        States and localities in planning for and mitigating potential 
        natural hazards with comprehensive disaster plans. This 
        planning should specifically address the needs of older adults, 
        people with disabilities, and their caregivers, in different 
        settings. It should also involve these individuals in the 
        development of the plans. Efforts should include disaster-
        resistant building codes, design regulations, and 
        infrastructure plans and preventing development in high-risk 
        zones.
   The Federal Government should also take a leadership role in 
        working with States and localities to regularly plan, execute, 
        and evaluate outreach and education activities to equip all 
        residents to shelter in place or evacuate safely. This includes 
        older adults, people with disabilities, people of color, people 
        who do not speak English, low-income persons, and other 
        difficult-to-reach populations.
   FEMA should have specific and detailed protocols that 
        address the needs of older adults and vulnerable populations in 
        disasters. FEMA should study the breakdowns in assistance that 
        occurred in previous disasters and use these lessons to guide 
        the development of new emergency response protocols.
   The Federal Government should engage in post-disaster 
        recovery efforts that reach all populations, including older 
        adults, people with disabilities, and their caregivers. This 
        includes providing technology infrastructure that enables rapid 
        communications and easy, transparent access to necessary 
        information. Disaster relief assistance and funding should be 
        distributed equitably, fairly, and expeditiously.
   Evacuation orders should specifically address the needs of 
        older adults, people with disabilities, and their caregivers, 
        as well as others who may need to remain in the community due 
        to special medical needs or other reasons. These orders should 
        be backed by pragmatic evacuation plans that provide sufficient 
        shelter space, including special needs shelters.
   Rebuilding and recovery efforts should promote livability 
        and resilience by encouraging:
     a diverse housing supply;
     a wide range of mobility options;
     access to safe, accessible, and sustainable public spaces; 
            and
     proximity to necessary services.
   Federal and State licensing standards should require that 
        nursing facilities and assisted living/residential care 
        facilities have well-developed, feasible, and practiced 
        emergency plans for residents, as well as adequate numbers of 
        well-trained staff to carry out such plans.
    In closing, thank you for the opportunity to testify before you 
today on this vital issue. Older adults endure the brunt of damage from 
disaster events and their unique needs must be addressed in National 
emergency preparedness, response and recovery policies, plans, and 
programs. We look forward to working with you on this critical matter.

    Mr. Payne. Thank you very much for your testimony. I now 
recognize Ms. Ammirati to summarize her statement for 5 
minutes.

     STATEMENT OF BARBARA AMMIRATI, SENIOR ADVISOR, CHILD 
                 PROTECTION, SAVE THE CHILDREN

    Ms. Ammirati. Thank you, Chairman Payne, Ranking Member 
Cammack, and honorable Members of the subcommittee. Thank you 
for the opportunity to provide testimony on behalf of Save the 
Children on the impact of disasters on children. In the United 
States and around the world, Save the Children works to give 
children a healthy start in life, the opportunity to learn, and 
also to protect children in crises. I want to thank Congress 
first for making the safety and well-being of children a 
priority with the recent passage of the Homeland Security for 
Children Act.
    Save the Children has responded to emergencies and 
humanitarian crises around the world for more than 100 years. 
In the United States, we are the national leader for child-
focused disaster response and recovery since 2005 when 
Hurricane Katrina devastated the Gulf Coast. Through our 
experience, we know that children are among the most vulnerable 
populations, that they are exceptionally affected by disasters, 
and suffer the most.
    We know that children of color and children from rural 
communities are particularly hard hit with the highest rates of 
food insecurity and least access to disaster recovery 
resources, including mental health recovery services. In the 
aftermath of Hurricane Harvey, it was the families of color in 
Houston, with long histories of chronically unstable housing, 
who remained in shelters the longest and whose children lost 
any sense of normalcy.
    I remember one 3-year-old boy who visited our child-
friendly space in the Greenpoint Mall shelter every day for 
weeks. He was a bit of a rabble-rouser and slowly we gained his 
trust and he endeared himself to the entire team. We were 
thrilled when his family received housing placement, but it was 
hard to say goodbye and wonder what would happen to him. Well, 
12 months later, our team responded to Hurricane Michael in 
Panama City, Florida. While setting up the child-friendly space 
in the school shelter, I was stunned to see that very same 
little boy from Houston now just 4 years old walk into the 
shelter. It broke my heart to think what brought him there and 
how his little life was completely upended not once but twice 
in the course of a year.
    I had a similar experience with Hurricane Katrina. As 
devastating as it was for everyone, the hurricane had much 
deeper impacts on children. The storm, unfortunately, was not 
the worst thing that had happened to them. They didn't need 
stuff. What they needed was caring adults and support systems.
    Based on Save the Children's on-the-ground experience, we 
know that while tremendous progress has been made, there is 
more to be done. We offer the following recommendations to the 
subcommittee: On education and influencing outcomes of a 
child's overall development, ensure that no displaced child is 
out of educational setting for more than 30 days. Ensure a 
robust return-to-learning policy framework that assesses the 
number of children out of school, limits the use of schools of 
as temporary shelters, expedites the rehabilitation and 
refurbishment of damaged schools, and establishes temporary 
learning spaces.
    On child care, which as we know, essential to the economic 
health and vitality of a community, Congress should please urge 
FEMA to designate child care as a critical service placing it 
at the same category as schools. And urge Congress to authorize 
a grant-funding mechanism to repair or rebuild for-profit child 
care facilities, to support the establishment of temporary 
child care, and reimburse States for subsidizing child care 
during disaster.
    On mental health, we urge Congress to ensure funding to 
support additional mental and behavioral health services in the 
aftermath of a large-scale disaster to supplement the depletion 
of existing resources and strengthen the backbone of American 
children. Congress and the Department of Education to award 
funds to States to implement and evaluate training of 
professional development programs for teachers on how to 
provide support to students before, during, and after disaster.
    On Government funding and accountability, to dedicate more 
funding to emergency preparedness, response, and recovery to 
lessen the gaps that remain to further support children. We 
urge Congress to include children into target capabilities with 
specific outcomes and performances. You cannot improve what you 
don't measure. Funding to implement, socialize, and 
institutionalize the good resources FEMA's tools and processes 
laid out in the Homeland Security for Children Act.
    And on cultural representation, Congress to urge all 
involved agencies to ensure that staff, volunteers, and 
Government representatives working in shelters adequately 
represent the communities being served.
    On behalf of Save the Children and our advocates, I want to 
thank the subcommittee for this opportunity to provide 
testimony on the needs of children in emergencies. I am 
submitting for the record a copy of my testimony with more 
detailed recommendations. I look forward to working with the 
Members of the subcommittee and to ensure that children and 
families receive the support they need to recover from 
disaster. Thank you.
    [The prepared statement of Ms. Ammirati follows:]
                 Prepared Statement of Barbara Ammirati
                             July 19, 2022
    Chairwoman Demings, Ranking Member Cammack, and honorable Members 
of the subcommittee, thank you for the opportunity to provide testimony 
on behalf of Save the Children about the impact of disasters on 
children. In the United States and around the world, Save the Children 
works every day to give children a healthy start in life, the 
opportunity to learn and protect children in crisis. We do whatever it 
takes for children--every day and in times of crisis--transforming 
their lives and the future we share.
                                 ______
                                 
    I want to start by thanking Congress for making the safety and 
well-being of children a priority with the recent passage of the 
Homeland Security for Children Act. By providing a permanent 
interagency coordinator that can ensure focused efforts, reduced 
duplication, and aligned resources for issues impacting children that 
must be addressed from multiple perspectives, children will have a 
better opportunity to recover from disasters. While progress has been 
made over the last decade to better protect children, there is more to 
be done.
    Save the Children has responded to emergencies and humanitarian 
crises around the world for more than 100 years. In the United States, 
we are the national leader for child-focused disaster response and 
recovery since 2005 when Hurricane Katrina devastated Gulf Coast 
States. Based on our expertise, Save the Children was tasked with 
chairing the Presidentially-appointed National Commission on Children 
and Disasters in late 2007.\1\
---------------------------------------------------------------------------
    \1\ National Commission on Children and Disasters. 2010 Report to 
the President and Congress. AHRQ Publication No. 10-M037. Rockville, 
MD: Agency for Healthcare Research and Quality. (2010).
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    Save the Children continues to respond to unprecedented extreme 
weather catastrophes and man-made disasters in the United States--
including more than 10 in the short time since Save the Children last 
testified before Congress in 2018. In addition, we have spent the last 
4 years providing emergency assistance for children and families at the 
U.S. Southern Border and the assisted in the extraordinary temporary 
resettlement of more than 100,000 Afghans in 2021. All of this work has 
been made even more difficult by the global pandemic.
    Research and evidence show that children are exceptionally affected 
by disasters. They suffer the most and are one of the most vulnerable 
populations after disasters--they can lose their parents, face food 
insecurity, and become homeless after floods, hurricanes, and other 
extreme weather catastrophes. We know that children of color and 
children from rural communities are particularly hard hit--with the 
highest rates of food insecurity and the least access to disaster 
recovery resources, including mental health recovery services.
    Children of color are also disproportionately represented in lower-
income, disaster-prone communities. Our disaster response experience 
demonstrates over and over again that communities of color struggle the 
longest and hardest in recovery from disasters. They take the longest 
to get back to school and early childhood learning environments.
    In the aftermath of Hurricane Harvey, families of color in Houston 
with long histories of chronically unstable housing remained in 
shelters the longest. Children were out of school and had none of their 
personal effects from homes that were destroyed. Our teams got to know 
these children and families well over the weeks and months--one 3-year-
old boy stands out. He visited our child-friendly space that was set up 
in a mega shelter at the Greenpoint Mall every day. He was a bit of a 
rabble-rouser and it was clear he had seen a lot in his little life, 
more than any 3-year-old should have to endure. He endeared himself to 
us and we managed to gain some semblance of his trust. It was hard to 
say goodbye--but we were thrilled when the family received housing 
placement and could leave the shelter.
    Twelve months later, we were responding to Hurricane Michael in 
Panama City, Florida. There were multiple shelters but the largest was 
at an elementary school that had been spared complete devastation. As 
we set up the child-friendly program for children in the shelter, I was 
stunned to see our little friend from Houston walk into the Panama City 
shelter with a sibling. What trauma for such a young child to 
experience twice in a 12-month period? It broke our hearts.
    Save the Children's on-the-ground experience responding to these 
disaster has shed light on critical gaps in the capacity of States and 
communities to protect children in emergencies and crises, and on 
valuable best practices that can help keep children safe. Based on this 
experience we offer the following recommendations to the subcommittee:
                 education recovery--return to learning
    Each year disasters have a major impact on children, youth, and 
education systems. Disasters of all sizes result in children missing 
school days, absenteeism by teachers who themselves may be affected by 
the disasters, disruption of learning, and school closures because of 
damage and destruction to classrooms and school infrastructure. For 
disaster-prone areas, this can mean that every year children may be 
losing critical hours of learning, which severely impact educational 
outcomes and a child's overall development.
    Additionally, when children have safe spaces to learn and play, and 
can access a full range of services and support, they are less 
vulnerable to the increased risks that go hand-in-hand with disasters. 
Schools can also provide children with the space they need to access 
psychological support and assist with regaining a sense of normality 
and healing from trauma.
    There are significant gaps in information/knowledge from the 
education sector on both the short- and long-term impacts disasters 
have on educational outcomes. A lack of official data collection and 
analysis of the number of children and schools affected by disasters 
inhibits coordination between response agencies, Government bodies and 
community organizations, and impacts the effectiveness of the response 
as a whole.
    In addition, operating costs associated with extra school days 
added to a school year as a result of disruption do not qualify for 
assistance under Stafford Act Sections 403 and 502, which provides 
emergency assistance to eligible public and nonprofit facilities, 
including schools.
    Congressional Recommendation.--Ensure that no displaced child is 
out of an educational setting for more than 30 days. Congress must 
enact policies with a commitment that no child misses more than a month 
of school, post-disaster. Current guidance to schools allows for up to 
60 days before recovery funding will be provided.\2\
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    \2\ https://rems.ed.gov/docs/PublicAssistanceProgramWebinar[1].pdf
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    A return-to-learning policy framework should include: Assessing the 
number of children out of school, the number of learning spaces needed, 
limiting the use of schools as temporary shelters, expediting the 
rehabilitation and refurbishment of damaged schools, establishing 
temporary learning spaces, and providing alternative education delivery 
programs (such as education in shelters or additional funding for 
after-school programming).
    Congress should ensure a permanent funding mechanism to support 
recovery for schools and students so that school systems recovering 
from disasters are provided immediate resources to reopen and restore 
the learning environment in a timely manner and provide support for 
displaced students and their host schools.
    We also urge Congress to task the newly-established role of 
Technical Advisor to initiate a study of the short- and long-term 
impacts of disasters on schools and the children they serve. Such a 
study can identify gaps in policy, implementation, data, and knowledge 
that will provide an evidence base to inform program and advocacy 
strategies, as well as seek to put more comprehensive numbers behind 
the stories of the impacts of disasters on children.
                          child care recovery
    Extensive research has shown that child care services are essential 
to the economic health and vitality of a community.\3\ During a 
disaster, workers with young children cannot resume their jobs unless 
there is safe, secure child care for their children.
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    \3\ http://www.mildredwarner.org/econdev/child-car.
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    Small private for-profit child care represents about two-thirds of 
licensed child care providers Nation-wide.\4\ Due to limited funding 
opportunities for private child care recovery, most facilities that are 
damaged or destroyed in a disaster receive little to no Federal 
recovery support.
---------------------------------------------------------------------------
    \4\ https://home.treasury.gov/system/files/136/The-Economics-of-
Childcare-Supply-09-14-final.pdf.
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    Congressional Recommendation.--While recognizing that child care is 
now considered to be a ``non-critical or essential service'' under 
FEMA's public assistance program, and deeming private non-profit child 
care eligible for disaster assistance, Congress should urge FEMA to 
designate child care as a ``critical service''. This would place it in 
the same category as schools, which would alleviate/loosen the 
requirement for child care facilities to apply for Small Business 
Administration (SBA) loans. Child care providers rarely receive SBA 
loans because their profit margins are so low. This has deterred many 
of these providers from even applying in the first place. In addition, 
we urge Congress to authorize a grant funding mechanism, such as an 
emergency contingency fund, to repair or rebuild private, for-profit 
child care facilities, support the establishment of temporary child 
care, and reimburse States for subsidizing child care services to 
disaster-affected families.
                          mental health needs
    Natural and man-made disasters frequently have wide-spread, deep, 
and enduring impacts on children's mental health. Many children 
experience long-term reactions to a disaster. Therefore, it is 
important that adults who care for children at schools and child care 
are trained to provide supportive services before, during, and after 
disaster, rather than relying exclusively on the traditional clinical 
approach of triage and referral.\5\
---------------------------------------------------------------------------
    \5\ [sic]
---------------------------------------------------------------------------
    The use of non-congregate or hotel-based shelter models throughout 
the pandemic to prevent the spread of COVID-19 mirrored lockdown, and 
isolated children and families already devastated by the loss of 
friends, family, property, and income. Studies suggest that the absence 
of routine and social isolation associated with lockdown has had 
significant impacts on the physical and mental health of children.\6\ 
The research also indicates that parents, now in hotel lockdown, 
experienced cumulative stressors through COVID-19 which impacted on 
their mental health and increased child abuse potential.\7\
---------------------------------------------------------------------------
    \6\ https://www.frontiersin.org/articles/10.3389/fpsyg.2021.722161/
full#B15.
    \7\ https://www.frontiersin.org/articles/10.3389/fpsyg.2021.722161/
full#:?:text=Studies%20- 
examining%20the%20impact%20of,et%20al.%2C%202020).
---------------------------------------------------------------------------
    Congressional Recommendation.--We urge Congress to ensure funding 
to support additional mental and behavioral health services in the 
aftermath of a large-scale disaster to supplement the depletion of 
existing resources and strengthen the backbone of America's kids.
    Congress and the Department of Education should award funds to 
States to implement and evaluate training and professional development 
programs for teachers on how to provide support to grieving students 
and students in crisis. States should also be encouraged to establish 
requirements related to teacher certification and recertification on 
these subjects. In addition, Congress should adequately fund the 
National Child Traumatic Stress Initiative (NCTSI) and Project SERV 
State grants to provide trauma treatment, programming, and services in 
schools and communities for children, youth, and families who 
experience or witness traumatic events.
    In light of the use of non-congregate or hotel-based shelter models 
throughout the pandemic, we urge Congress to task the newly-appointed 
Technical Advisor with evaluating the impact of family isolation on 
displaced children and families during and following a disaster. This 
data would be critical to inform future use of non-congregate shelter 
practice.
                  government funding & accountability
    The biggest obstacle to supporting children through disaster 
response and recovery is inadequate funding. Robust funding and strong 
accountability structures are required to meet the needs of children. 
While the United States invests billions of dollars to support 
emergency preparedness and response, very often children's needs are 
overlooked. While we congratulate Congress on passing the Homeland 
Security for Children Act which will help highlight children's needs in 
emergency response adequate funding is needed and in particular to 
include children into target capabilities with specific outcomes and 
performance measures. ``You can't improve what you don't measure.''\8\
---------------------------------------------------------------------------
    \8\ https://www.forbes.com/sites/civicnation/2022/06/29/thanks-to-
my-queerness-i-am/?sh=6f47987331af.
---------------------------------------------------------------------------
    Congressional Recommendation.--Congress, through the appropriations 
process, has the responsibility to fund the Federal Government in such 
a way as to meet the needs of children. We need to dedicate more 
funding to emergency preparedness, response, and recovery to lessen the 
gaps that remain and further support children.
    Funding to implement, socialize, and institutionalize FEMA's 
resources, tools, and processes laid out in the Homeland Security for 
Children Act to address and meet children's needs at every level of 
Government is critical and include children into target capabilities 
with specific outcomes and performance measures.
                        cultural representation
    Culturally Sensitive Trauma-Informed Care is critical for children 
in times of crisis. In order for health care professionals to provide 
effective trauma-informed assessment and intervention, it must take 
into account a patients' and families' cultural values, beliefs, and 
practices. At the absolute minimum, children and families need to be 
able to communicate with shelter staff and other professionals in their 
language of choice. For example, in our hurricane response in North 
Carolina, care for families and children was delayed significantly by 
the lack of translation services for a large Swahili population in the 
region.
    Congressional Recommendation.--Congress should urge all involved 
agencies to ensure staff, volunteers, and Government representatives 
working in shelters adequately represent the community being served. 
This is especially important for children and families seeking health 
and psychological supports, as cultural differences can have a variety 
of impacts ``ranging from the ways in which health and illness are 
perceived, health-seeking behavior, attitudes of the consumer, as well 
as the practitioners and mental health systems''.\9\
---------------------------------------------------------------------------
    \9\ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6018386/.
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                               conclusion
    On behalf of Save the Children, and our advocates across the 
country, I want to thank the subcommittee for the opportunity to 
provide testimony on the needs of children in emergencies here in the 
United States. I look forward to working with the Members of the 
subcommittee to ensure that children and families receive the support 
they need to recover from disaster.

    Mr. Payne. Thank you for your testimony. I now recognize 
Ms. Roth to summarize her statement for 5 minutes.

    STATEMENT OF MARCIE ROTH, EXECUTIVE DIRECTOR AND CHIEF 
        EXECUTIVE OFFICER, WORLD INSTITUTE ON DISABILITY

    Ms. Roth. Good morning, Chairman Payne, Ranking Member 
Cammack, and distinguished Members of the subcommittee. It is 
an honor to testify before you today as one voice among the 26 
percent of the U.S. population who have disabilities and who 
are continually underserved and left behind before, during, and 
after disasters. I am the CEO of World Institute on Disability, 
founded by people with disabilities 40 years ago. I have spent 
the past 20 years focusing on disability-inclusive emergency 
management and improving disaster outcomes for the whole 
community, including almost 8 years as senior advisor to FEMA 
Administrator Craig Fugate, establishing and leading FEMA's 
Office of Disability, Integration, and Coordination until 2017.
    We are still failing people with disabilities, especially 
multiply-marginalized people before, during, and after 
disasters. We need your help to address urgent, immediate, 
life-saving steps FEMA, HHS, DHS, DOJ, HUD, and State, local, 
Tribal, and territorial emergency management can take to serve 
disaster-impacted people and communities being left out and 
left behind. They have not adequately implemented, monitored, 
or enforced their obligations to ensure compliance with 
disability civil rights laws in the use of huge amounts of 
taxpayer funds. Because they have denied guidance, technical 
assistance, and funding for access to life-saving and life-
sustaining resources, emergency management at every level has 
severely underserved people with disabilities of all ages, 
primarily multiply-marginalized disabled Black, Brown, 
Indigenous, other people of color, LGBTQIA+, and other 
intersecting identities experiencing poverty in urban and rural 
communities.
    Unfortunately, for the past 5 years, FEMA has made it 
almost impossible for national disability leaders from across 
the country to work collaboratively with their Office of 
Disability Integration, Office of Equal Rights, and their 
leadership. Of well over 1 million people who have died from 
COVID since 2020, most were people with pre-existing 
conditions, comorbidities, and other terms used to describe 
disabilities. Over 200,000 of them were disabled people of all 
ages in congregate facilities, death pits, as described by The 
New York Times. To be clear, people don't go to nursing homes 
and other institutions because they are old. They go because 
they have disabilities and need community support that their 
community fails to provide to them.
    The World Institute on Disability has been actively 
participating with the Partnership for Inclusive Disaster 
Strategies on their daily calls, focusing on the urgent needs 
of people with disabilities impacted by COVID and concurrent 
disasters. Disability leaders have met each and every day since 
February 28 of 2020. We meet on weekends and holidays and we 
are almost always joined by the American Red Cross, Centers for 
Disease Control and Prevention, and community leaders from 
across the country. FEMA is invited daily; however, they do not 
attend.
    One of our key areas of focus is on optimizing the use of 
the Federal disaster declarations and the Stafford Act to 
protect disabled people and disaster-impacted communities. 
Independent living centers have a mandate to divert and 
transition people with disabilities from nursing homes under 
Federal law. We have tried to utilize this mandate to relocate 
people to safer, non-congregate settings to protect them from 
COVID and other infections spreading rampantly in these 
congregate facilities.
    Since 2020, we have implored Administrator Gaynor, Acting 
Administrator Fenton, and 11 months ago, we met with and begged 
Administrator Criswell to guide emergency managers to work with 
us to utilize the non-congregate shelter and reimbursement 
option under FEMA Public Assistance Category B emergency 
protective measures to save lives. We know this option is 
viable because Roads to Freedom in Central Pennsylvania has 
successfully received reimbursement for life-saving relocation.
    While trying to navigate FEMA assistance, many, many others 
have died. Twenty people seeking relocation in one community 
died while waiting for approval from emergency management to 
agree to relocation. According to AARP, rates of COVID-19 cases 
and deaths in nursing homes rose in June for the second month 
in a row. Resident deaths increased by 54 percent compared to 
the previous month. How many of these deaths could have been 
prevented? How many more can we prevent, starting today, if 
FEMA were to prioritize the use of emergency protective 
measures for assisting people with disabilities to relocate out 
of congregate facilities and divert others from being admitted 
with the help of experts from Centers for Independent Living?
    Please support equity in access and--I am sorry--equality 
in access and equity in outcomes. Please help us pass the Real 
Emergency Access for Aging and Disability Inclusion Ready for 
Disasters Act----
    Mr. Payne. Ms. Roth.
    Ms. Roth [continuing]. The Disaster Relief Medicaid Act, 
and let's build forward better, not back. And please tell FEMA 
to work with us. Thank you.
    [The prepared statement of Ms. Roth follows:]
                   Prepared Statement of Marcie Roth
                             July 19, 2022
    Good morning, Chairman Demings, Ranking Member Cammack, and 
distinguished Members of the Subcommittee on Emergency Preparedness, 
Response, and Recovery. It is an honor to testify before you today, as 
one voice among the 26 percent of the U.S. population, 1 in 4 adults, 
who have disabilities and who are continually underserved and left 
behind before, during, and after disasters.
    I am the executive director and chief executive officer of the 
World Institute on Disability, one of the first global disability 
rights organizations, founded in 1983 by people with disabilities and 
continually led by disabled people for almost 40 years.
    I have been active in the disability rights movement since I was in 
high school and have worked as an advocate for the rights and needs of 
people with disabilities throughout my 45-year career. Along the way, I 
acquired my disability, raised two disabled children, married a man 
with a disability, became the proud grandmother of an amazing 3-year-
old with a disability and, though some don't own it, most of my family 
and friends have disabilities, too.
    My laser focus on emergency preparedness, improving disaster 
outcomes for people with disabilities and building accessible disaster-
resilient communities began in the immediate aftermath of the September 
11, 2001 terrorist attacks, when I was asked to advise the White House 
on the rights and urgent needs of thousands of New Yorkers with 
disabilities living in the area around ground zero.
    Appointed by President Obama to the U.S. Department of Homeland 
Security--Federal Emergency Management Agency from 2009 to 2017, I 
served as senior advisor to Administrator Fugate, establishing and 
directing the FEMA Office of Disability Integration and Coordination. I 
also served as FEMA's Congressionally-mandated disability coordinator; 
a requirement established when the Post-Katrina Emergency Management 
Reform Act (PKEMRA) amended the Stafford Act in 2006.
    I am here today because, despite my very best efforts, my work and 
the work of many others has failed to improve disaster outcomes for 
people with disabilities. This is especially and disproportionately 
true for disabled multiply-marginalized Black, Brown, Indigenous and 
other People of Color, LGBTQIA+, and other intersecting identities.
    In fact, I am horrified to have to testify that I think people with 
disabilities are in even greater peril today than when I last testified 
before this committee in 2019.
    However, after spending nearly 8 years in a leadership position at 
FEMA, and many more years providing guidance, tools, training, and 
technical assistance to local, State, National, Tribal, territorial, 
Federal, and international emergency management stakeholders, I am 
confident that emergency management can center the needs and rights of 
the people and communities most disproportionately affected by 
disasters and by doing so, improve disaster resilience for the whole 
community.
    In one week, on July 26, 2022, the 32nd anniversary of the 
Americans with Disabilities Act will be celebrated. This law, known as 
the ADA, gives civil rights protections to individuals with 
disabilities similar to those provided to individuals on the basis of 
race, color, sex, national origin, age, and religion. The ADA also 
assures equal opportunity for individuals with disabilities for access 
to businesses, employment, transportation, State and local government 
programs and services, and telecommunications. These rights are never 
suspended or waived, including before, during, and after public health 
emergencies and disasters.
    In 1971, a New York judge described people with disabilities as 
``the most discriminated [against] minority in our Nation.'' Two years 
later, the Rehabilitation Act of 1973 which requires equal physical 
access, program access, and equally effective communication access was 
passed. Almost 50 years old, this law applies to EVERY Federal dollar 
spent, including all funds expended by the Federal Government before, 
during, and after disasters, and every Federal dollar spent by grantees 
and sub-grantees, including States, Tribes, territories, and their 
subgrantees from cities and counties and any other user of Federal 
funds.
    In the words of one of the original authors of the ADA, Bob 
Burgdorf, written in the Washington Post, ``The ADA was a response to 
an appalling problem: Widespread, systemic, inhumane discrimination 
against people with disabilities.
    However, it wasn't until passage of the Post-Katrina Emergency 
Management Reform Act (PKEMRA) in 2006 that non-discrimination on the 
basis of disability was added to the Stafford Act.
    Even today, FEMA frequently cites ``Federally-supported, State-
managed, Locally-executed'' as an excuse for failures in serving people 
with disabilities in violation of civil rights laws. While this may be 
an acceptable excuse when it doesn't involve Federal funds, FEMA's 
obligations (and the obligations of all funders of Federal financial 
assistance) to comply and to ensure their grantees and subgrantees 
comply remain solidly in place, without exception.
               equality in access and equity in outcomes
    Having a disability does not make people more vulnerable in 
disasters. Everyone is potentially vulnerable to the impacts of 
disasters. What makes people vulnerable is the failure of communities 
and governments to plan for the equal access and equitable outcomes for 
people with disabilities in every aspect of the disaster cycle, 
including community preparedness and disaster exercises, accessible 
alerts, and warnings, building and community evacuation, sheltering and 
temporary housing, access to health maintenance and medical services, 
and all aspects of the recovery process.
    Both equality and equity are important but are not interchangeable. 
Equity means fairness, and that everyone gets what they need. While we 
are reaching and striving for equity, it is not an alternative to 
equality. Equal access is one imperative aspect of achieving and 
maintaining equity. Equal access for people with disabilities is a 
legal, civil rights obligation, never waived or diminished in a 
disaster. Incrementalism is not an acceptable or permissible 
alternative to complying fully with the law. The Government's 
commitment to equity is laudable, and necessary, but no one is ``off 
the hook'' when it comes to equal access to programs, services, places, 
or information for people with disabilities, before, during or after a 
disaster.
    One of the most egregious failures of the Federal Government is 
failing to monitor and enforce equal access obligations that cannot, 
must not be ignored when spending or granting tax dollars to others to 
spend. The most egregious failure is continuing to look the other way, 
shrugging shoulders, or letting years of inaction pass with when these 
violations are brought to the attention of officials who have the 
responsibility to act.
                       underserved and underheard
    When I was at FEMA, Administrator Fugate made it very clear to me 
right from the start of my appointment and throughout my almost 8 years 
as his senior advisor that my top priority was disability community 
engagement. This included meeting regularly with National, State, and 
local disability leaders, sending dozens of disability advisors into 
disaster-impacted communities during FEMA response to Federally-
declared disasters, developing and delivering training and technical 
assistance to support emergency managers and stakeholders on how to 
meet the access and functional needs of the whole community, inclusive 
of, but not limited to people with disabilities.
    Since 2017, FEMA leadership has actively and systematically 
dismantled most community engagement mechanisms, significantly 
decreased the disability expert workforce, shut down existing training 
and failed to provide any new training.
  in a 2017 government accountability office report, federal disaster 
  assistance: fema's progress in aiding individuals with disabilities 
                       could be further enhanced
    GAO found that ``ODIC also has not established goals for how many 
State and local emergency managers should take its key training on 
integrating the needs of individuals with disabilities into disaster 
planning. Nor has ODIC evaluated alternative methods to deliver the 
training more broadly, such as virtually in addition to classroom 
training. As a result, State and local emergency managers may be ill-
prepared to provide effective disaster services to those with 
disabilities.''
    Five years later, one recommendation from that report is marked 
``closed-implemented'' and the other two remain ``open''.
    Among the 1,000+ courses available through the FEMA Emergency 
Management Institute and funded by tax dollars, there are currently two 
courses that mention disability. One, IS: 368 referred to in the report 
as ``closed-implemented'', is a short video developed in 2014 and never 
updated, and the other, IS: 1019, is specifically focused on disaster 
recovery ``codes and standards''.
    In 2019, after a bipartisan request from co-chairs of every 
relevant House and Senate committee, including the House Committee on 
Homeland Security. Another GAO report was published ``Disaster 
Assistance: FEMA Action Needed to Better Support Individuals Who Are 
Older or Have Disabilities''. This report included 7 new 
recommendations. Of those, 5 of the recommendations are noted as 
``closed-implemented'' however, one is a time line to offer training to 
FEMA's partners. Another that is still open is that ``The FEMA 
Administrator should develop a plan for delivering training to FEMA 
staff that promotes competency in disability awareness. The plan should 
include milestones and performance measures and outline how performance 
will be monitored.''
    In another ``closed-implemented'' recommendation to update 
``Integrating Access and Functional Needs into Emergency Planning'' it 
is noted that ODIC officials ``expect to field the course starting in 
August 2020''. As of July 2022, this course, has been unavailable for 5 
years, surely contributing to underserving disaster-impacted people 
with disabilities and other marginalized people.
    At the same time, the frequency, intensity, and duration of 
disasters of all kinds is growing exponentially. The disproportionate 
impact on people with disabilities and other marginalized people is 
exacerbated by the failures of the Federal Government to implement, 
monitor, and enforce the laws that protect the people most likely to be 
harmed. Basic access to power, potable water, heating, and cooling is 
taken for granted by most people, yet these are among the most deadly 
effects of climate-driven disasters, along with fires and floods.
    During this period, our Nation has experienced 84 separate billion-
dollar weather and climate-related disasters, many other disasters 
costing less than $1 billion, other Federally-declared disasters 
unrelated to weather, and, of course COVID disasters and public health 
emergencies, both in place since early 2020. This includes all 50 
States, the District of Columbia, 5 territories, and 32 Tribes.
    The U.S. Departments of Justice, Health and Human Services, 
Homeland Security, Housing and Urban Development, and FEMA have all 
confirmed that disability civil rights laws are NEVER waived or 
suspended, including in a disaster. Even when waivers of other laws are 
granted in a Federally-declared disaster, those waivers never apply to 
the ADA and the Rehabilitation Act, nor do they apply to the non-
discrimination requirements in the Stafford Act.
    Despite this, the Centers for Medicare and Medicaid have repeatedly 
issued waivers in public health emergencies that allow States to bypass 
many of the protections that keep people with disabilities out of 
institutions, nursing homes, and other congregate facilities, in direct 
violation of their rights. These Section 1135 of the Social Security 
Act blanket waivers have been issued repeatedly over the past several 
years with dire consequences for people with disabilities, despite 
their ADA, Stafford, and Rehabilitation Act rights.
    I have repeatedly raised these concerns for years, including in a 
formal complaint in 2017, filed with the Departments of Justice, Health 
and Human Services, Homeland Security, and FEMA. I was granted a 
``listening session'' hosted by the Disability Rights Section of the 
Department of Justice in November 2017. Representatives from HHS and 
DHS attended, FEMA RSVPed to DOJ that they would attend, but never 
showed up.
    In my one-way conversation, while everyone ``listened'', I 
requested that these Federal representatives exercise their obligation 
to enforce disability rights laws since the civil rights of people with 
disabilities are never allowed to be waived or suspended. I never heard 
another word about my complaint and the issuance of 1135 blanket 
waivers continued in many subsequent disasters, including the current 
COVID-19 pandemic, beginning in January 2020 and reissued by HHS 
Secretary Becerra 4 days ago on July 15, 2022.
    The National Council on Disability (NCD) is an independent Federal 
agency charged with advising the President, Congress, and other Federal 
agencies regarding policies, programs, practices, and procedures that 
affect people with disabilities. In May 2019, NCD published Preserving 
Our Freedom: Ending Institutionalization of People with Disabilities 
During and After Disasters. In NCD's cover letter to President Trump, 
former Presidential appointee NCD Chairperson Neil Romano told the 
President, ``NCD has found that people with disabilities are frequently 
institutionalized during and after disasters. The report examined 
factors that led to institutionalization. Then, most critically, it 
provided recommendations to eliminate institutionalization of people 
with disabilities during and after disasters. It also recommended how 
to improve community readiness to meet obligations that require equal 
access to emergency and disaster services and programs in the most 
integrated setting appropriate for disaster-impacted people.'' Chairman 
Romano told President Trump, ``There will be no remedy in future 
disasters without sweeping changes.''
    On March 3, 2020, in anticipation of what disability leaders feared 
was to come, disability advocates led by the Partnership for Inclusive 
Disaster Strategies, the National Council on Independent Living 
Emergency Preparedness Subcommittee, and my organization, the World 
Institute on Disability issued a National Call to Action joined by 194 
other local, national, and international groups.
    The coalition followed our Call to Action with a letter to Vice 
President Pence and the White House COVID-19 Task Force on March 9, 
2020.
    It took many complaints before CMS amended their COVID-19 1135 
blanket waiver guidance, adding one line to the document originally 
published 4 months earlier. The added language reads, ``States are 
still subject to obligations under the integration mandate of the 
Americans with Disabilities Act, to avoid subjecting persons with 
disabilities to unjustified institutionalization or segregation.
    In a footnote, CMS also added ``Please note that consistent with 
the integration mandate of Title II of the ADA and the Olmstead vs LC 
decision, States are obligated to offer/provide discharge planning and/
or case management/transition services, as appropriate, to individuals 
who are removed from their Medicaid home and community-based services 
under these authorities during the course of the public health 
emergency as well as to individuals with disabilities who may require 
these services in order to avoid unjustified institutionalization or 
segregation. Transition services/case management and/or discharge 
planning would be provided to facilitate these individuals in their 
return to the community when their condition and public health 
circumstances permit.'' This did not stem the placement of people with 
disabilities in COVID-infested nursing homes.
    Advocates also had to move quickly to prevent children and adults 
from having their medical care and medical devices rationed based 
simply on their disability and the perceived quality of their life. 
Both implicit and explicit biases were further threatening the lives of 
people with disabilities.
    ``The Center for Public Representation and others filed complaints 
alleging that crisis standard of care plans in two of the States being 
hardest hit by COVID-19, Arizona and Texas, discriminate against people 
with disabilities, older adults, and people of color, placing these 
communities at risk of substantial and imminent harm--and the real risk 
of being denied basic and emergency treatment--during the pandemic.
    In response to the disability community's strong advocacy, the U.S. 
Department of Health and Human Services' Office of Civil Rights (HHS 
OCR) published a bulletin on March 28, 2020 to ensure that covered 
entities follow civil rights laws, including Section 1557 of the 
Affordable Care Act and Section 504 of the Rehabilitation Act which 
``prohibit discrimination on the basis of disability in HHS-funded 
health programs or activities.'' The guidance explains that entities 
funded by HHS cannot deny people with disabilities medical care ``on 
the basis of stereotypes, assessments of quality of life, or judgments 
about a person's relative `worth' based on the presence or absence of 
disabilities.'' It also discussed the obligations of hospitals to 
ensure equal access and effective communication.
    In many States, efforts have been taken to provide immunity to all 
hospitals, nursing homes, and other congregate facilities, protecting 
those facilities and their employees from any criminal or civil 
liability for their treatment decisions and actions. Families, 
disability advocates and advocates for older adults are outraged. One 
advocate in New York told The New York Times ``Having liability can 
cause a facility to be more diligent and prevent incidents occurring 
that will cost them money,'' said Susan M. Dooha, the executive 
director of the Center for Independence of the Disabled. ``The 
preventive power of liability has been muted.''
    For 2 years, countless people have been institutionalized in 
understaffed, under-resourced COVID-infested congregate facilities, 
with waivers in place that have resulted in continual denial of basic 
human rights, huge data gaps and even bigger loss of life. On April 22, 
2022, CMS updated their use of blanket waivers in place for over 2 
years. Absent from their update was elimination of nursing home 
admission flexibilities, to meet the needs of providers, NOT people 
being admitted without civil rights and life safety protections in 
place.
                     collaboration and partnership
    The World Institute on Disability believes collaboration and 
partnership between disability-led organizations like ours and 
government and non-government organizations must be among our highest 
priorities. Through our work with the Partnership for Inclusive 
Disaster Strategies, we have been closely collaborating, coming 
together each and every day, at 6pm ET since February 28, 2020 with a 
laser focus on addressing the urgent needs of people with disabilities 
throughout the COVID-19 public health emergency and concurrent 
disasters, including those driven by the impact, duration, and 
intensity of climate change.
    We are joined almost every day by representatives from the U.S. 
Department of Health and Human Services (HHS) Centers for Disease 
Control and Prevention (CDC), the American Red Cross, emergency 
managers and disability community leaders from across the country. The 
U.S. Department of Homeland Security (DHS) Office for Civil Rights and 
Civil Liberties (CRCL) and the HHS Administration for Community Living 
(ACL) join at least weekly.
    Despite extending continual invitations from the Partnership for 
Inclusive Disaster Strategies, the FEMA Office of Disability 
Integration and Coordination (ODIC) and the FEMA Office of Equal Rights 
(OER) rarely join us or participate in any of the Partnership's other 
invitations to collaborate. (Over the past 2 months, the ODIC acting 
director has begun to attend some meetings, however he rarely shares 
any information and has been unable to answer our questions.)
    This is our ONLY shared communication since a large group of 
disability-led organizations and our allies met with FEMA 
Administrator, Deanne Criswell almost 1 year ago in August 2021 to 
share our urgent concerns about the needs of disaster-impacted people 
with disabilities. At that meeting, Administrator Criswell assured us 
that FEMA's Disability Coordinator and both ODIC and OER would follow 
up and work more collaboratively moving forward. This statutory 
obligation is included in the Post-Katrina Emergency Management Reform 
Act (PKEMRA) mandate for the Disability Coordinator to ``consult with 
organizations that represent the interests and rights of individuals 
with disabilities about the needs of individuals with disabilities in 
emergency planning requirements and relief efforts in the event of a 
natural disaster, act of terrorism, or other man-made disaster'' among 
other statutory obligations. Despite Administrator Criswell's 
assurances, our contact from ODIC has only been in the form of 
announcements from the office and the last correspondence of any kind 
was in November 2021. While we were included in the audience for the 
FEMA Equal Rights Summit in November 2021, we've had no follow-up 
communication from OER, no summary, findings, transcript, or other 
output from that meeting.
    To summarize, there has been no collaboration, no coordination, no 
dialog, and no effort to seek community engagement or consult with a 
broad array of disability-led organizations.
    Since November, COVID has raged, with Omicron causing devastating 
impact that has disproportionately affected people with disabilities of 
all ages. Recently, the Kaiser Family Foundation reported what we 
already knew, that as of 1/30/22, there have been over 200,000 deaths 
in nursing homes, with countless disabled people of all ages dying in 
other long-term care, carceral, psychiatric, and other facilities.
    According to the Kaiser Family Foundation, ``This death count is 
based on State and Federal data sources. For the period between March 
2020 and June 2021, the total number of deaths is based on State-
reported data on LTCFs, including nursing homes, assisted living, and 
group homes, that summed to 187,000 resident and staff deaths. For the 
subsequent period between July 2021 and January 2022, we incorporated 
data reported to the Federal Government by nursing facilities 
(excluding other types of LTCFs), adding another 14,000 resident and 
staff deaths to the total. The total number of resident and staff 
deaths from these two sources, roughly 201,000, is likely an undercount 
of the true number of resident and staff deaths in LTCFs since it 
excludes deaths in long-term care settings other than nursing homes 
after June 30th, 2021. Additionally, not all States reported data on 
all types of LTCFs prior to June 2021.''
    And from the Covid Tracking Project at the Atlantic: Using State 
and Federal data, we can estimate that as of March 2021: ``About 8 
percent of people who live in U.S. long-term-care facilities have died 
of COVID-19--nearly 1 in 12. For nursing homes alone, the figure is 
nearly 1 in 10.
    ``The most complete figures we can assemble are both an estimate 
and a severe undercount of the true impact on long-term-care residents. 
Because of the historical deaths missing from both State and Federal 
data, non-standard State reporting, and the absence of Federal 
reporting requirements for long-term-care facilities, we believe that 
the true toll of the pandemic among these residents is higher than 
these figures can show. Read our analysis or use our data.
    ``Throughout the pandemic, long-term-care facility deaths made up 
over a third of all U.S. deaths based on COVID Tracking Project (CTP) 
data, which includes nursing homes, assisted living and other long-term 
care facilities. The Center for Medicare & Medicaid Services (CMS) only 
reports data for nursing homes, where a quarter of deaths in the U.S. 
occurred. The impact on these communities is likely higher than this 
figure shows because of missing historical deaths from both State and 
CMS data, and inconsistent, non-standardized reporting by States.''
    You may not think FEMA has a primary role in preventing the death 
of hundreds of thousands of disabled people in nursing homes and 
countless others denied personal assistance and personal protective 
equipment in the community. However, disability leaders have been 
trying to work together with FEMA leaders on life-saving and life-
sustaining efforts related to the pandemic since the very first days 
after COVID was declared a national disaster on March 13, 2020. We 
focused very specifically on the dire circumstances in congregate 
settings and the opportunity to relocate people with disabilities to 
non-congregate settings as an emergency protective measure, already 
covered under FEMA Public Assistance, Category B (Cat B). We knew Cat B 
was being used to relocate unhoused people and that Centers for 
Independent Living (CILs) are Congressionally-mandated to transition 
people with disabilities out of these settings, and also divert others 
from admission as one of their core services. This was an opportunity 
to work together to save hundreds of thousands of lives. CILs 
understood they would have to fund relocation costs and wait for 
reimbursement from their State. Some attempted to get their county and 
State to work with them. So far, only one county and one State has 
worked with one CIL; Roads to Freedom Center for Independent Living of 
North Central PA, to save one person through emergency relocation 
utilizing Cat B Emergency Protective Measures.
    Many other disabled people have died as their CIL attempted to 
navigate across their county, State, and FEMA to help them put needed 
Memoranda of Agreements in place. They were repeatedly told that FEMA 
wouldn't allow this use of Public Assistance reimbursement.
    Guidance from FEMA has not been forthcoming, and even now, after 
Roads to Freedom received reimbursement for life-saving emergency 
relocation, FEMA has not accepted our invitations to work together to 
help more States to save disabled lives. There has been no guidance 
offered by FEMA to optimize the equitable use of Cat B to improve 
disaster outcomes for people with disabilities or to enforce the 
requirements that come with use of Federal funds by FEMA's grantees and 
subgrantees in compliance with their civil rights obligations.
    KFF noted that ``COVID-19 deaths in LTCFs make up at least 23 
percent of all COVID-19 deaths in the U.S.'' Further, ``nursing homes 
have continued to experience disproportionately high case and death 
rates in the country during the recent surge. Higher case rates may be 
attributed to the highly transmissible nature of Omicron and the nature 
of congregate care settings.''
    There have been at least 20,000 COVID deaths in nursing homes since 
Administrator Criswell was appointed. Many of these deaths occurred 
after Roads to Freedom successfully navigated emergency relocation for 
which FEMA has subsequently reimbursed relocation costs to the State of 
PA, who subsequently reimbursed Roads to Freedom.
    According to the American Association of Retired People, ``rates of 
COVID-19 cases and deaths in nursing homes rose in June for the second 
month in a row, ending several months of decline from the peak of the 
initial Omicron wave in January 2022.
   The rate of resident cases increased by 27 percent in the 4 
        weeks ending 6/19/22, compared to the previous 4 weeks. About 1 
        out of every 35 nursing home residents tested positive for 
        COVID-19 in this 4-week period.
   The rate of staff cases increased by 42 percent compared to 
        the previous 4 weeks. About 1 staff member tested positive for 
        COVD-19 for every 28 residents.
   More than one-third of nursing homes had a resident case 
        during the 4 weeks ending 6/19/22, and two-thirds of facilities 
        had a confirmed staff case.
   The rate of resident deaths increased by 54 percent compared 
        to the previous month. About 1 out of every 1500 residents died 
        from COVID-19 in the last month.''
    How many of these deaths could have been prevented? How many more 
can we prevent, starting today, if FEMA were to prioritize the use of 
emergency protective measures for assisting people with disabilities to 
relocate out of congregate facilities and divert others from being 
admitted with the help of experts from CILs?
    The World Institute on Disability (WID), The Partnership for 
Inclusive Disaster Strategies, and our allies from across the country 
would like to rebuild what was once a collaborative relationship with 
FEMA. We want to work with FEMA Headquarters and in the Regions in a 
shared effort to close systematic gaps that prevent FEMA from meeting 
its commitment to ``integrate equity as a foundation of its culture'' 
and fully accomplish its mission to help ALL people, before, during and 
after disasters, including disabled people.
    We shared our stakeholder perspective on our top 10 FEMA priorities 
for 2022 earlier this year:
    1. Talk directly and regularly with disability-led organizations 
        who work on disability-inclusive emergency management. We 
        expect to be at the table and not the door. Bring in a mediator 
        if necessary.
    2. Work with us to save disabled lives now. It's too late for 
        hundreds of thousands of people with disabilities who could 
        have been prevented from dying from COVID, but it's not too 
        late for people, including multiply-marginalized people with 
        disabilities, who could be assisted by the network of 
        disability-led organizations across the country who want to 
        work with FEMA.
    3. Co-host a summit with national disability-led organizations on 
        Disability, Equity, Rights, Compliance, and the equitable use 
        of Disaster Funds to jointly focus on improving the equitable 
        use of Federal disaster resources
    4. Provide Guidance to SLTTs on:
        1. FEMA Personal Assistance Services Addendum
        2. Recent Disaster Assistance Application changes
        3. Transparent reporting on all Rehabilitation Act monitoring, 
            compliance, and enforcement in all funds granted to States 
            from FEMA.
        4. Utilizing disability-led organizations as a primary source 
            of qualified, culturally-appropriate Disaster Case 
            Management.
        5. Engaging disability-led organizations throughout the 
            development, control, play and review of exercises at all 
            levels.
    5. Recognize CILs and other community-based disability 
        organizations as eligible Private Non-Profits in the next 
        update of the Public Assistance Program and Policy Guide. 
        (Pages 45-47).
    6. Provide monthly reports on the long-delayed revision of E/L 197 
        and other relevant training issues highlighted in the February 
        2017 GAO report on training with emphasis on meeting disability 
        rights obligations and achieving disability equity.
    7. Convene a workgroup including disability-led organizations to 
        identify and address gaps between Emergency Support Functions 6 
        and 8.
    8. Meet with disability-led organizations working on the midpoint 
        review of the United Nations Sendai Framework for Disaster Risk 
        Reduction 2015-2030.
    9. Co-host a summit with national disability-led organizations on 
        implementing a realistic Personal Assistance Services plan and 
        performable contracts for Federal as well as SLTT.
    10. Co-host a summit with national disability-led organizations on 
        implementation and improvement of the Integrated Public Alerts 
        and Warnings System to meet the notification requirements for 
        equally effective communication access for people with 
        disabilities in disaster
                        priorities for congress
Among the many issues we are asking this committee to prioritize, 
        please include the following:
    Focus on disability inclusive preparedness, response, and recovery 
centering the people and communities most disproportionately 
underserved and left behind.
   Please help us find out who is monitoring and enforcing FEMA 
        and HHS's use of disaster funds to ensure that every Federal 
        dollar spent or granted to others to spend are in full 
        compliance with all of the obligations under the Rehabilitation 
        Act of 1973? We can't seem to get that answer and can't seem to 
        get an answer for who is responsible for monitoring and 
        enforcing the agencies required to monitor and enforce the 
        expenditure of billions--perhaps trillions of taxpayer dollars!
   Are we centering our efforts on the disaster needs of 
        multiply-marginalized Black, Indigenous, Brown, and other 
        People of Color? LGBTQIA+ people?
   Are the rights and needs of disabled prisoners and detainees 
        in carceral facilities prioritized in emergency and disaster 
        planning?
   What efforts are being taken to ensure the inclusion of 
        people with intellectual disabilities, autistic people, people 
        with mental health needs, people under guardianship and other 
        disabled people who are most often the most excluded from 
        emergency planning?
   Why are funds being directed to improve nursing homes when 
        they very obviously are incapable of protecting the people in 
        their facilities from infections, including deadly COVID-19? 
        Invest funds in home and community-based services and 
        accessible housing!
   Who is responsible for monitoring the GAO findings regarding 
        FEMA's obligations to people with disabilities? Despite several 
        recent reports about the failures of the Office of Disability 
        Integration and Coordination, several agreements remain 
        unfulfilled and although GAO reported that they weren't 
        conducting a civil rights review, many disability civil rights 
        violations have been documented and remain unresolved. If GAO 
        is not responsible for addressing these documented civil rights 
        violations, who is?
   Are people with disabilities involved in planning, 
        participating in, and reviewing disaster exercises?
   Do they get alerts and warnings in formats accessible to 
        them? Has the Integrated Public Alerts and Warning Act 
        adequately addressed all accessibility requirements? 
        Information must be accessible to be actionable.
   Can they evacuate from multistory buildings? Can they 
        evacuate the community with everyone else, even if they need 
        accessible transportation, or are they left behind?
   Are shelters prepared to meet their access and functional 
        needs?
   Will service and emotional support animals be welcomed? 
        Despite relentless efforts, people with service animals are 
        still repeatedly denied access to shelters.
   Has there been any guidance provided for assisting people 
        with disabilities who request reasonable accommodations for the 
        application process when they apply?
   Will national disability organizations finally be invited to 
        work with FEMA's Office of Disability Integration and 
        Coordination after being refused time and again since 2017?
   How can provision of personal assistance and other 
        accommodations be improved? There is still a need for immediate 
        solutions to prevent admissions to nursing homes and other 
        COVID-19-infested congregate facilities.
   There is a national shortage of accessible and affordable 
        housing before disasters destroy homes. This must be a priority 
        or the cascade that leads to institutionalization won't be 
        stemmed.
   Likewise, we must prioritize Home- and Community-based 
        Services funding to prevent institutionalization and provide 
        the resources for nursing home transition and other 
        deinstitutionalization for all who wish to live in the 
        community, without exception.
   Meeting the educational needs of students with disabilities 
        remains an especially urgent need during the pandemic. The 
        disaster-related needs of students with disabilities have been 
        an issue in every recent disaster, and this must be addressed 
        so that planning can prevent the disproportionate interruption 
        of the educational needs of these students, in violation of 
        their rights under the Individuals with Disabilities Education 
        Act.
   Disaster recovery and mitigation must always start with a 
        commitment to universal design standards and accessibility as 
        imperatives. Without accessibility, community resilience is 
        impossible.
   Immediately pass the bi-partisan, bi-cameral Real Emergency 
        Access for Aging and Disability Inclusion for Disasters (REAADI 
        for Disasters Act)--and Disaster Relief Medicaid Act (DRMA). 
        These bills will go a long way toward closing many of the 
        deadly gaps in disasters and public health emergencies, not 
        just for people with disabilities, but for the whole community.
    Based on the findings of the 2019 report, Preserving Our Freedom: 
Ending Institutionalization of People with Disabilities During and 
After Disasters, NCD recommends that:
   The Department of Justice (DOJ), the Department of Health 
        and Human Services (HHS), the Department of Homeland Security 
        (DHS), and the Department of Housing and Urban Development 
        (HUD) monitor and enforce the Americans with Disabilities Act 
        (ADA) Olmstead integration mandate and the Rehabilitation Act 
        obligation to use Federal funds in such a way that people are 
        served in the most integrated setting appropriate to their 
        needs.
   All relevant Federal agencies engage with National, State, 
        and local coalitions of disability-led organizations and 
        stakeholders.
   DOJ assesses the equal access and non-discrimination civil 
        rights compliance performance of the American Red Cross and 
        other shelter and mass-care providers in relation to actions 
        resulting in institutionalization of disaster survivors with 
        disabilities.
   The Federal Emergency Management Agency (FEMA) explore ways 
        to expeditiously modify its Individual Assistance registration 
        process to curtail the incidence of institutionalization of 
        individuals with disabilities.
   DHS/FEMA and HHS/Administration for Community Living (ACL) 
        provide grant funds to support Independent Living Centers in 
        supporting disaster-impacted people with disabilities in their 
        community. (This funding should incorporate all five core 
        services of Independent Living Centers, including their 
        obligation to prevent and divert institutionalization of 
        disaster-impacted people throughout disaster response and 
        recovery.)
   Relevant Federal agencies integrate disaster-related 
        services for veterans with disabilities with all other 
        emergency and disaster services in order to address the current 
        gap in coordination.
   Legislation be introduced and swiftly enacted to address all 
        gaps in meeting the civil rights obligations to people with 
        disabilities impacted by disasters.
    Recommendations from the Emergency Relocation of Congregate Setting 
Residents letter to the National Governors Association:
   Relocate residents to safe, non-congregate, cohort settings 
        that house no more than one person per room
   Identify residents who want to transition to Home- & 
        Community-based Services (HCBS)
   Require that institutions/long-term care facilities grant 
        access to essential CIL staff and transition coordinators in 
        order to implement these relocation plans
   Expedite HCBS eligibility determinations for those who want 
        to remain in the community OR who refuse to return to an unsafe 
        congregate setting
   Work with your Department of Commissioners, etc. to utilize 
        alternative funds (such as FEMA Public Assistance Category B 
        funds) to cover the costs of care, shelter, and food during 
        disaster relocations
   Immediately lift the restrictions on visitations. Data shows 
        visits from family are critical to the well-being and quality 
        of life of people housed in these congregate settings. Not 
        allowing visitations is contributing to the increases in death.
    And, the Partnership for inclusive Disaster Strategies led our 
COVID-19 Coalition to issue the following Legislative Recommendations 
for Public Health Emergencies and Disasters:
    To meet the urgent and immediate needs of people with disabilities, 
including multiply-marginalized people, throughout the COVID-19 Public 
Health Emergency, Presidential Disaster Declarations, concurrent 
disasters and in preparation for future disasters and public health 
emergencies:
   There must be the establishment and funding of one or more 
        Disability, Emergency, and Disaster Technical Assistance 
        Centers led and managed by disability inclusive emergency 
        management experts, operational within 30 days of enactment in 
        order to meet the immediate life-saving and life-sustaining 
        needs and protecting the rights of 61 million adults with 
        disabilities and for others who also have access and functional 
        needs in a disaster or public health emergency.
    Purposes of the Disability, Emergency and Disaster Technical 
Assistance Centers:
   Operating a National Disability Disaster and COVID-19 Rights 
        and Needs Hotline
   Developing and delivering remote just-in-time training on 
        the COVID-19 rights and needs of people with disabilities, with 
        a specific focus on:
   The rights and immediate needs of people with disabilities 
        who need supports and services to protect themselves from 
        exposure.
   People with disabilities who are in quarantine.
   People with disabilities who are in isolation or in an acute 
        care medical setting.
   Information for medical, public health, and public safety 
        officials, government and non-government, and private-sector 
        entities to understand their obligations to people with 
        disabilities, before, during, and after public health 
        emergencies and disasters.
   Meeting continuity of operations and continuity of services 
        for serving people with disabilities across the life cycle and 
        throughout the disaster cycle.
   Public engagement, coordination between all public and NGO 
        stakeholders to provide accessible information, promising and 
        good practices, and problem-solving via disability accessible 
        teleconference and web-based information sharing.
   Crisis counseling and Disaster Case Management for people 
        with disabilities, eligible as a result of Federal Disaster 
        Declarations. Crisis counseling and Disaster Case Management 
        must be provided by disability culturally competent providers, 
        and must be equally effective for all people with communication 
        disabilities. Crisis Counseling and Disaster Case Management 
        must be provided without interruption and gaps. Auxiliary aids 
        and services to make communication equally effective include 
        sign language interpreters, real-time captions, CART, plain 
        language, easy read, Braille, large print, screen reader and 
        other alternative formats. Alternative and augmentative 
        communication is used by many people with disabilities to meet 
        their daily communication needs. For people with COVID-19 whose 
        ability to communicate may be temporarily affected, equal 
        access to crisis counseling can be provided by utilizing 
        auxiliary aids and services to meet their urgent crisis 
        communication needs.
   Amendment to Stafford Act--Use of Disaster Response and 
        Recovery Funds
   Fund certain ``nonprofit entities'' in Category B language--
        amended to define funding for a training & technical assistance 
        center.
   Funding for disability-led organizations providing life-
        saving and life-sustaining assistance in a Federally-declared, 
        Stafford Act-eligible disaster or emergency.
   Fund State, local, Tribal, and territorial government 
        entities to track the displacement of people with disabilities 
        into skilled nursing facilities (SNF) and other institutions 
        with or without the use of a CMS 1135 Blanket Waiver.
   Require and fund Federal, State, local, Tribal, and 
        territorial government entities to ensure disability services 
        and supports are provided in the most integrated settings 
        appropriate to the person.
   If the person is in an acute care setting, all reasonable 
        accessibility accommodations and modifications of policies and 
        practices are provided without interruption.
   To maintain all reasonable accessibility accommodations and 
        modifications of policies and practices are provided without 
        interruption at home and throughout transition home from an 
        acute care or institutional setting.
   Increase Home- and Community-based Services (HCBS) funding
   Expand funding for Money Follows the Person (MFP)
   Fund Federal entities to monitor recipients and 
        subrecipients of Federal funds to ensure compliance throughout 
        all disaster-related placement decisions by recipients and 
        subrecipients of Federal financial funds within 30 days, and 
        with quarterly reports to Congress.
    Additional recommendations for legislative action are all drawn 
from the 5/24/19 report from the National Council on Disability report 
to President Trump: Preserving Our Freedom: Ending Institutionalization 
of People with Disabilities During and After Disasters:
   Require CMS to establish a process for Medicaid portability 
        and continuity of services within States and among States, 
        Tribes, and territories during disasters and public health 
        emergencies to ensure uninterrupted health maintenance and 
        medical care in the least restrictive environment for Medicaid 
        recipients.
   Require that all recipients and subrecipients of Federal 
        funds receive just-in-time training in the scope of their 
        obligations to people with disabilities. This training must be 
        developed and delivered by disability-led organizations with 
        knowledge, skills, and abilities. This training must include 
        information advising that Federal funds may be revoked due to 
        noncompliance with the obligation to receive services in the 
        most integrated setting appropriate and that this obligation 
        applies during disasters.
   Training on the scope of the obligations of recipients and 
        subrecipients of Federal financial assistance to people with 
        disabilities during the period of hospitalization and discharge 
        for individuals impacted by public health emergencies and 
        disasters, including those who have been abandoned during 
        evacuation, sheltering, and transition to long-term housing.
   Funding will be provided to disability-led organizations to 
        deliver technical assistance to local, State, Tribal, 
        territorial, and Federal agencies responsible for emergency 
        preparedness, community resilience, and disaster-related 
        services, programs, supports, or activities to engage with 
        national, State, and local coalitions of disability-led 
        organizations and stakeholders.
   Fund NCD to lead a review of the National Response 
        Framework, Emergency Support Function Annexes, and Federal 
        Interagency Operations Plans and all other applicable Federal 
        doctrine to determine any required updates to specifically 
        address responsibility for meeting the equal access, health 
        maintenance, safety, and independence needs of children and 
        adults with disabilities to prevent institutionalization.
   Fund an organization with expertise in IDEA, ADA, Rehab Act 
        and Stafford Act to assess and make recommendations that 
        disaster-impacted students with disabilities are not excluded 
        from distance learning and returning to school with their peers 
        and that all supports and services included on their IEP or 
        Section 504 plan are provided without interruption. This 
        includes providing services during school closure and upon 
        school reopening in order to meet their individualized 
        educational needs and to prevent institutionalization.
   Fund a comprehensive assessment of with recommendations for 
        the establishment and execution of a seamless and integrated 
        process in Emergency Support Functions No. 6 and No. 8 to 
        prioritize health maintenance for children and adults with 
        disabilities and seamlessly deliver services and supports to 
        people in the most integrated setting throughout the 
        evacuation, sheltering, hospitalization, temporary housing, and 
        disaster recovery. Recommendations must include actionable 
        steps for the HHS Secretary's Operations Center and the FEMA 
        Emergency Support Function Leadership Group to ensure the 
        rights and needs of people with disabilities are maintained 
        throughout the period of a declared public health emergency and 
        disaster.
   Establish a roster of Federal agencies who must provide 
        senior leadership participation and active engagement in a 
        community-led public-private partnership with disability 
        organizations with specific expertise and involvement in 
        national disability inclusive emergency management policy and 
        practice.
   Authorize and appropriate funds for DHS and FEMA to provide 
        disaster preparedness grants specifically targeted to 
        organizations led by and serving marginalized communities, 
        including but not limited to people with disabilities 
        experiencing poverty; people with disabilities experiencing 
        homelessness; women with disabilities; people of color with 
        disabilities; and members of the LGBTQ community with 
        disabilities.
   Provide funding and quarterly reporting by DOJ, DHS, and HHS 
        to monitor and enforce the obligation under both the ADA and 
        the Rehabilitation Act to serve people with disabilities in the 
        most integrated setting appropriate to their needs.
   Fund the FCC to reestablish its Emergency Access Advisory 
        Committee to establish effective communication access 
        requirements for alerts, warnings, and notification, including 
        provision of American Sign Language and other existing and new 
        assistive technology. These guidelines should be developed in 
        consultation and collaboration with DOJ, applying the 
        requirements for equal effective communication access. 
        Implementation should include monitoring and enforcement by the 
        FCC and DOJ.
   Fund immediate operations and research into solutions for 
        existing disability service providers (such as independent 
        living centers, paratransit service providers, meals on wheels, 
        medical supply providers, developmental disability service 
        providers, personal assistants, direct support professionals, 
        birth to 3, ADRCs, AAA, sign language interpreters, peer 
        support, respite, etc to jointly plan for, share information, 
        and meet the emergency and disaster needs of the people one or 
        more of them maintain in their database.
   Fund research on HIPAA and Privacy Act laws to determine if 
        and how they need to be revised to allow providers to share 
        information and resources in emergencies and disasters. This is 
        an alternative to the use of ``special'' registries that 
        repeatedly fail to provide a solution for meeting the civil 
        rights obligations the Government has to people with 
        disabilities in emergencies and disasters.
   Fund NCD to review the Federal Mass Evacuation Plan, DRRA, 
        and PKEMRA evacuation planning requirements, and any other 
        plans that use Federal funding for evacuation be reviewed by 
        the Department of Justice, Department of Transportation, 
        Department of Homeland Security, and other Federal agencies 
        with a role in planning, implementing, and/or funding 
        evacuation initiatives to ensure compliance with disability 
        civil rights obligations throughout disaster response and 
        implement all necessary corrective action immediately.
   Fund HHS CMS to develop and implement within 30 days, a 
        comprehensive Federal database in collaboration with all other 
        Federal entities with admission and monitoring or funding and 
        reimbursement obligations to ensure that all admissions to 
        hospitals and long-term care facilities during and after 
        disasters are monitored at every admission and discharge and 
        that people placed are provided with the assistance needed to 
        return to their community with all supports and services they 
        need to regain and maintain their independence. Reporting to 
        Congress must begin NLT 60 days and must continue quarterly 
        until all admissions from the start of a declared emergency 
        (including public health emergency) and disaster have returned 
        home (or died).
   Fund DOJ and other Federal entities with enforcement 
        authority to monitor and prohibit the automatic placement of 
        individuals with disabilities in hospital and nursing home 
        settings and direct State and local entities to immediately 
        provide supports and services in the most integrated setting 
        appropriate to any person who does not need this level of care. 
        Monitor and enforce civil rights compliance with Titles II and 
        III of the ADA regarding sheltering.
   Fund DOJ, DHS, and HUD to monitor and enforce compliance 
        with obligations for emergency sheltering in a disaster 
        consistent with emergency sheltering requirements under the 
        Fair Housing Amendments Act. Compliance should occur in 
        transient and long-term emergency shelters.
   Congress funds all elements of the REAADI and DRMA Acts not 
        otherwise specified in these recommendations to ensure that the 
        rights of people with disabilities are protected and that the 
        needs of people with disabilities and older adults are met in 
        concurrent and future disasters.
    This includes:
   Establish a National Research Center to conduct research and 
        collect and analyze data to determine recommended practices for 
        including people with disabilities and older adults in planning 
        during and following disasters. Establish a ``projects of 
        National significance'' program to increase the involvement of 
        people with disabilities and older adults in the planning and 
        response to disasters.
   Establish a National Commission on Disability Rights, Aging, 
        and Disasters that will provide recommendations on how to 
        ensure effective emergency preparedness, disaster response, 
        recovery, and community resilience efforts for people with 
        disabilities and older adults.
   Establish 1 National and 10 regional Training and Technical 
        Assistance Disability and Disaster Centers that provide 
        comprehensive training, technical assistance, development of 
        funding sources, and support to State, Tribal, and local 
        disaster relief; public health entities; social service 
        agencies; and stakeholder groups.
   Require and fund DOJ to create an oversight committee that 
        will review all ADA settlement continued agreements related to 
        disaster-response activities for the years 2005 to 2017.
   Medicaid Relief for Disaster Survivors:
     Amending the Social Security Act to provide medical 
            assistance available to relief-eligible survivors of 
            disasters during relief coverage periods in accordance with 
            section 1947.
     Disaster Relief Medicaid for Survivors of Major Disasters.
     Promoting Effective and Innovative State Responses to 
            Increased Demand for Medical Assistance Following a 
            Disaster.
     HCBS Emergency Response Corps Grant Program.
     Targeted Medicaid Relief for Direct Impact Areas.
     Presumptive and Continuous Eligibility, No Documentation 
            Required.
   Fund DOJ to provide pointed guidance to sister Federal 
        agencies to address the issue of outdated regulations that 
        conflict with the Olmstead integration mandate.
   Fund the University of Minnesota Institute on Community 
        Integration University Center on Excellence in Disabilities 
        Residential Information Systems Project (RISP) to expand their 
        research on institutionalization during and after disasters in 
        all States and territories to include people with all types of 
        disabilities.
   Fund DOJ to assess the equal access and non-discrimination 
        civil rights compliance performance of the American Red Cross 
        and other shelter and mass care providers in relation to 
        actions resulting in institutionalization of disaster survivors 
        and issue orders for immediate corrective actions as needed.
   Fund DOJ to issue a fact sheet that defines monitoring and 
        enforcement obligations in order to ensure compliance with 
        civil rights requirements in the placement, as well as to track 
        and use of Federal funds associated with emergency and disaster 
        sheltering of people with disabilities.
   Fund Independent Living Centers and other affordable and 
        accessible housing experts to provide individual and household 
        disaster case management focused on the transition and 
        permanent housing needs of disaster-impacted people with 
        disabilities.
   Fund Independent Living Centers and other experts on 
        affordable and accessible housing to provide individual and 
        household disaster case management focused on the transition 
        and permanent housing needs of disaster-impacted people with 
        disabilities during concurrent and future disasters.
   Fund HUD to establish metrics and measure the Nation-wide 
        availability of the ready supply of accessible, adaptable, 
        affordable, and disaster-resistant permanent and temporary 
        housing.
   Fund FEMA and HUD to create systems for collecting and 
        publishing all disaster recovery and mitigation expenditures 
        for housing that is subject to compliance with requirements 
        under the Rehabilitation Act, Fair Housing Amendments Act, and 
        the ADA. This reporting systems must measure and report 
        compliance with accessibility standards.
   Fund DOJ to monitor and enforce civil rights compliance 
        throughout all phases of disaster response to: (a) Prevent 
        abandonment on the part of Government entities, such as 
        National Guard and other recipients and subrecipients of 
        Federal financial assistance, (b) Ensure compliance throughout 
        all disaster-related placement decisions made by recipients and 
        subrecipients of Federal financial assistance, (c) Ensure 
        compliance with Titles II and III of the ADA pertaining to 
        sheltering.
   Fund FEMA to explore ways to modify their Individual 
        Assistance registration process expeditiously to curtail the 
        incidence of institutionalization of individuals with 
        disabilities during concurrent and future disasters.
   Fund the DHS Office for Civil Rights and Civil Liberties to 
        lead and manage the 25-plus Federal agencies included in 
        Executive Order 13347, which established the Interagency 
        Coordinating Council on Emergency Preparedness and Individuals 
        with Disabilities (ICC), to collaborate to ensure moving 
        forward that emergency preparedness plans incorporate the 
        perspectives and needs of individuals with disabilities, and 
        that barriers to access, services, and planning are removed.
   Fund member agencies of the ICC to place disability experts 
        from their agency into the field during Federally-declared 
        disasters in all FEMA Joint Field Offices and Area Field 
        Offices throughout disaster operations. These experts must be 
        qualified by either the FEMA Qualification System or the 
        National Qualification System to ensure adequate expertise in 
        guiding compliance with the civil rights of disaster-impacted 
        people with disabilities to prevent institutionalization during 
        concurrent and future disasters.
   Fund HHS to establish a process for States and territories 
        to immediately loan and replace durable medical equipment, 
        consumable medical supplies, assistive technology, and 
        disability services and supports, well as disaster case 
        management to disaster survivors with disabilities, in order to 
        provide equal access and non-discrimination throughout 
        emergency response to meet immediate health, safety, and 
        independence needs.
   Fund the Veterans Administration and HHS to ensure disaster-
        related services for veterans are integrated with all other 
        emergency and disaster services to address the current gap in 
        coordination between services for veterans with disabilities 
        and services for other people with disabilities.
   Fund the immediate provision of experts on reasonable 
        accommodations for every disaster applicant until such time as 
        applicants with disabilities can request and receive these 
        reasonable accommodations through the FEMA application.
                         one last thing . . . 
    Our Federal complaint process does not work in disasters. Waiting 
until there is measurable harm to an eligible complainant before the 
complaint can be acted upon probably doesn't work well under any 
circumstances. It most definitely doesn't work in a disaster. We must 
have a process for immediate action when a rights violation is about to 
occur. This includes failing to provide accessible alerts and warnings, 
accessible building evacuation and transportation, shelters without 
accessible bathrooms and showers, lack of access to resources to 
maintain health, safety, and independence, turning service animals and 
emotional support animals away from shelters, failing to keep people in 
the most integrated setting appropriate to their needs, failing to 
provide equally effective communication access, plain language, 
reasonable modifications, meet specific dietary needs, separating 
families and natural supports, forcing people into medical settings to 
access electricity and so many other rights violations. If we had a way 
to intervene before the harm occurred, lives would be saved, disaster 
outcomes would improve and the whole community would benefit.
                               in closing
    One of my favorite sayings is associated with the Chinese symbols 
for Crisis, Danger, and Opportunity. ``Crisis is an opportunity riding 
on a dangerous wind.''
    In these very troubled times, we all face three choices. Do we 
``build back'' to what wasn't working before? Do we stay stuck right 
where we are until the next catastrophic event forces us to scramble 
again, or do we use this unprecedented opportunity to boldly build 
FORWARD, riding the fierce wind that is blowing, all of us, to create 
and sustain a resilient country that prioritizes equity and equality 
for the people who will once again be left behind if we don't act.
    I choose the bold commitment to equity, resilience, and justice for 
all and I ask you to join me in turning words into action.
    Thank you for listening.

    Mr. Payne. Thank you. Thank you very much for your 
testimony. I now recognize Mr. Antoine B. Richards to summarize 
his statement for 5 minutes.

STATEMENT OF ANTOINE B. RICHARDS, CHIEF OF STAFF, INSTITUTE FOR 
        DIVERSITY AND INCLUSION IN EMERGENCY MANAGEMENT

    Mr. Richards. Excellent, thank you. Excuse me. Chairman 
Payne, Ranking Member Cammack, and Members of the Subcommittee 
on Emergency Preparedness, Response, and Recovery, I thank you 
for the opportunity to testify before you today on the highly 
significant topic of supporting underserved communities in 
emergency management. My name is Antoine Richards and I serve 
as chief of staff of the Institute for Diversity and Inclusion 
in Emergency Management. I-DIEM has been a strong advocate for 
vulnerable, underserved, and marginalized populations having 
previously testified before Congress on topics including 
Experiences of Vulnerable Populations During Disasters, 
Ensuring Equity in FEMA's Disaster Preparedness, Response, and 
Recovery, and Health Disparities and the Novel Coronavirus 
Pandemic. Our work is dedicated to the empowerment of 
marginalized communities within all phases of the disaster 
management cycle to promote a more resilient and sustainable 
future.
    Whether hosting virtual equity roundtables with communities 
from Alaska to Miami, deploying equity response teams following 
Hurricane IDA in the Midwest tornadoes, or working directly 
with communities and Tribal nations in the Mississippi Delta 
and coastal Louisiana, the experiences of our communities 
remain the same. Our most underserved communities express 
stories of exclusion, lack of access and awareness to funding, 
lack of understanding of complex administrative, bureaucratic 
processes, and an overall lack of support from Federal, State, 
and/or local government.
    While progress is being made toward the integration of 
equity in strategic priorities, measures, and initiatives, the 
structural processes that have created inequity remain the 
same. Policies such as the Stafford Act in our current disaster 
declaration process remain relatively the same.
    The suffering of communities remains the same. The 
disproportionate impacts of disasters remain the same. As 
disasters increase in frequency and strength, there is less 
time for adequate recovery among our Nation's most vulnerable 
communities contributing to increased suffering. We must change 
the way we do emergency management. We must do disasters 
differently. We must focus on the communities that we serve.
    I-DIEM's on-the-ground efforts allow us to truly engage, 
listen, and learn from the experiences of our communities, 
opportunities to learn from the decimated walls of houses, and 
see face-to-face the tears of the individuals, families, and 
communities that suffer within a system that structurally 
denies them the assistance and resilience of their wealthier 
counterparts. We see the devastation of these communities for 
weeks and months on end, understanding that recovery may never 
be a possibility because the next major disaster is always 
around the corner due to the current climate crisis.
    It is the responsibility of Congress, policy makers, and 
emergency managers Nation-wide to protect its citizens. Whether 
intentionally or unintentionally, we all play our part in the 
disparities that underserved communities face by operating 
within the constraints of policies, practices, and programs 
that create barriers to resilience. As the current climate 
crisis continues to bear impact socially, culturally, and 
economically, we can no longer afford to seek temporary 
solutions and initiatives without addressing the root causes of 
vulnerability.
    We must do disasters differently. We must invest in our 
communities and put our communities at the forefront of our 
work as public servants. Our policies should be people-centric 
and focused on what can be achieved within the context of our 
communities. To achieve this, we offer the recommendations that 
it is imperative to incorporate policies that support 
community-based funding, indoctrinate sustainability measures 
for equity initiatives, prioritize funding and accountability 
mechanisms, improve the understanding of communities through 
vulnerability assessments and community profiles, and take 
legislative and budgetary authority through our agencies and 
through Congress and policies to integrate equity in programs 
and policies.
    As an organization, we applaud Congressman Thompson and the 
House of Representatives for the introduction and passing of 
the FEMA Equity Act, which supports FEMA in its efforts in 
instilling equity as a foundation of emergency management. 
Further, we recognize the current administrator's efforts to 
instill equity as a priority in FEMA policies, programs, and 
procedures. These actions represent a key example of how we can 
begin to stop the suffering and do disasters differently.
    I-DIEM recognizes that there is still work to be done and 
improved outcomes cannot be done alone. The responsibility lies 
with you and it requires equity-focused policy and approaches 
as cornerstones of a more resilient future. I thank you for the 
time today and the opportunity to share this testimony. Thank 
you.
    [The prepared statement of Mr. Richards follows:]
               Prepared Statement of Antoine B. Richards
                             July 19, 2022
    Chairwomen Demings, Ranking Member Cammack, and Members of the 
Subcommittee on Emergency Preparedness, Response, and Recovery, thank 
you for the opportunity to testify before you today on this highly 
significant topic of supporting underserved communities in emergency 
management. My name is Antoine Richards, and I serve as chief of staff 
of the Institute for Diversity and Inclusion in Emergency Management 
(I-DIEM). I-DIEM has been a strong advocate for vulnerable, 
underserved, and marginalized populations having previously testified 
before Congress on topics including ``Experiences of Vulnerable 
Populations During Disasters,'' ``Ensuring Equity in FEMA's Disaster 
Preparedness, Response, and Recovery,'' and ``Health Disparities and 
the Novel Coronavirus (COVID-19) Pandemic.'' Our work is dedicated to 
the empowerment of marginalized communities within all phases of the 
disaster management cycle to promote a more resilient and sustainable 
future.
    Whether hosting Virtual Equity Roundtables with communities from 
Alaska to Miami, deploying Equity Response Teams following Hurricane 
Ida and the Midwest tornadoes, or working directly with communities and 
Tribal nations in the Mississippi Delta and coastal Louisiana, the 
experiences of our communities remain the same. Our most underserved 
communities' express stories of exclusion, lack of access and awareness 
to funding, lack of understanding of complex administrative, 
bureaucratic processes, and an overall lack of support from Federal, 
State, and/or local government. While progress is being made toward the 
integration of equity in strategic priorities, measures, and 
initiatives, the structural processes that have created inequity remain 
the same.
    The Nation's most vulnerable, underserved, and marginalized 
communities have been pushed to the outskirts of our Nation and the 
wallows of urban civilization establishing a tone for discrimination 
whether by age, income, race or ethnicity, disability, sexual 
orientation, gender, culture, and geographic location. Each of these 
factors create the culture of our communities and the fabric of our 
society while also serving as the foundation that defines underserved 
communities and outlines inequities within each subpopulation. Elderly, 
low-income, BIPOC, individuals with access and functional needs, 
LGBTQIA+, women, children, and rural communities are experiencing 
decreased quality of life and access due to policy, programs, and 
practices which will inevitably be exacerbated by the current climate 
crisis.
    From 1980-present, the United States has sustained 332 weather- and 
climate-related disasters where overall damages/costs reached or 
exceeded $1 billion for a total cost of $2.275 trillion. By decade, we 
averaged $5.5 billion events per year in the 1990's, $6.7- in the 
2000's, $12.8- in the 2010's, $17.8- per year in the last 5 years, 
$18.7- in the last 3 years, and last year ranked second in the total 
number of billion-dollar events from this time frame. Currently, the 
United States has experience 9 separate billion-dollar disasters from 
January-June without reaching peak hurricane season placing us on par 
for another record year in terms of extreme weather events and 
costs.\1\
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    \1\ Billion-Dollar Weather and Climate Disasters/National Centers 
for Environmental Information (NCEI) (noaa.gov).
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    The steady increase in frequency and strength of disasters during 
our current climate crisis contributes to a decrease in adequate 
recovery and resilience among our communities. There is inadequate time 
to effectively recover before experiencing the next major disaster. 
Moreover, we often hear stories from our communities that resources for 
response and recovery often do not reach underserved communities while 
research consistently shows that poverty rate and higher proportions of 
racial and ethnic populations typically receive less funding support 
for mitigation, preparedness, response, and recovery.\2\ This is 
further exacerbated for communities with pre-existing vulnerabilities 
which suffer from the complexities of meeting basic daily needs. 
Moreover, the compounding impacts of the COVID-19 pandemic continue to 
spotlight disparities among our most marginalized communities as cases 
surge to approximately 100,000 new cases daily among reported cases \3\ 
and the burden of the virus on people of color, low-income, and other 
structurally disadvantaged populations remain prevalent.\4\
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    \2\ Sullivan, P., Sutley, E., Wu, Y., Lyles, L.W. (2022). Who gets 
Federal financial resources to mitigate and recover from disasters? 
National Hazards Workshop [Virtual Poster Presentation].
    \3\ Sullivan, P. (2022). COVID-19 cases are on the rise. Does it 
matter anymore? The Hill. COVID-19 cases are on the rise. Does it 
matter anymore? (yahoo.com)
    \4\ Wasfy, J.H., Hidrue, M.K., Rockett, H., Cafiero-Fonseca, E.T., 
Ferris, T.G., del Carmen, M.G. (2021). Socioeconomic and demographic 
characteristics of both inpatients and outpatients with positive 
testing for SARS-CoV-2. Journal of General Internal Medicine, 36, 2522-
2524.
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    Taking into account both climate change and the COVID-19 pandemic, 
an estimated 100 million people are expected to be pushed into poverty 
globally by 2030.\5\ For the United States, there is a projected 
increase in poverty levels approximately 30 percent over the next 10 
years while climate change will exacerbate negative poverty trends 
within our communities. This indicates a shift where the projected 
costs will continue to rise under our current system and communities 
will continue to suffer unless we effectively adapt our approach to 
emergency management to better understand and support underserved 
communities.
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    \5\ Mahler, D.G., Lakner, C., Aguilar, R.A.C., Wu, H. (2020). 
Updated estimates of the impact of COVID-19 on global poverty. The 
World Bank. Updated estimates of the impact of COVID-19 on global 
poverty (worldbank.org).
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    In recent reports from the State Resilience Partnership, findings 
reveal that 84 percent of State flood plans do nor, or only minimally, 
consider how flooding will disproportionately affect vulnerable 
communities. While 82% of state flood plans identify counties as 
responsible for implementation at the community level, only 39% of 
plans include specific strategies to assist low-capacity communities. 
Moreover, public engagement efforts were often associated with new and 
experimental initiatives that connect State-level strategy to local 
communities that engage directly with local communities however most 
State flood planning efforts involved little to no public outreach.\6\ 
Subsequently, the whole-community approach continues to exclude the 
whole community contributing to negative impacts which the Institute 
has witnessed first-hand through our on-the-ground efforts. Our 
approaches must improve upon our understanding of underserved 
populations to influence effective strategy and change.
---------------------------------------------------------------------------
    \6\ State Resilience Partnership (2022). State flood planning 
landscape. Planning. Planning--State Resilience Partnership.
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    For example, 26 percent of Tribal nations are currently living 
below poverty level \7\ while 66 percent of Tribes have no community 
disaster plans or family resources. Moreover, through our work with 
Tribal nations in coastal Louisiana, we understand that Tribal nations 
without Federal and/or State recognition have decreased access to 
funding and, reliance on Federal, State, and local governments to 
ensure the safety and support of these nations, as U.S. citizens, has 
only increased the negative impacts of disasters nationally. Moreover, 
while policy and programs are often strongly-rooted data, research and 
engagement among Tribal nations is often limited creating a barrier to 
substantial, necessary change. Challenges of Tribal nations are also 
greatly impacted by limited access and resources within rural 
communities. Compared to urban areas, access to resources for rural 
communities are often complex and vulnerable people in rural 
populations are at increased risk to disasters as result.
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    \7\ Krogstad, J.M. (2014). One-in-four Native Americans and Alaska 
natives are living in poverty. Pew Research Trust. One-in-four Native 
Americans and Alaska Natives are living in poverty/Pew Research Center.
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    Bearing the burden of chronic disease, COVID-19, and poverty due to 
access issues (i.e., access to healthy food, access to affordable 
health care, and underinsured or uninsured individuals and families), 
low-income communities and communities of color face additional 
barriers related to environmental justice and disasters. From an 
environmental perspective, Black and Latino communities are often 
situated in high-hazard locations and breathe 56 percent and 63 percent 
more pollution than they produce, respectively.\8\ From an emergency 
management perspective, communities with higher poverty rates and 
higher proportions of Black residents often receive less funding in 
Hazard Mitigation Assistance and Individual Assistance. Additionally, 
counties with higher percentages of minority residents typically 
receive less funding than the value of damage assessed by FEMA during 
inspection.\2\ This aligns with a long-standing focus on widening 
racial wealth gaps as a result of disasters which highlighted higher 
accumulated wealth after disaster among white communities opposed to 
communities of color.\9\ In addition, for communities where English is 
a second language (ESOL), language barriers contribute to inequitable 
access to communication and resources as well as effective community 
engagement strategies while cultural familial structures contribute to 
common disparities indicative of communities of color. It is these same 
familial structures that are affected by gender inequities that find 
women and children 14x more likely to than men to die during a disaster 
often as a result of gender and cultural norms present in our 
society.\10\
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    \8\ Tessum, C.W., Apte, J.S., Goodkind, A.L. (2019). Inequity in 
consumption of goods and services adds to racial-ethnic disparities in 
air pollution exposure. Social Sciences, 116(13), 6001-6006.
    \9\ Howell, J. (2018). Natural disasters widen racial wealth gap. 
Social Problems. Natural disasters widen racial wealth gap/EurekAlert!
    \10\ International Union for Conservation of Nature [IUCN] (n.d.). 
Disaster and gender statistics. Microsoft Word--Disaster and Gender 
Statistics.doc (unisdr.org)
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    Individually, inequities rooted in these social determinants are 
impactful; however, with underserved communities, it is worth looking 
beyond individual contexts and exploring the intersections of each 
variable and how they influence outcomes among underserved communities 
creating compounding vulnerability. For example, the intersection of 
gender and income shows that vulnerability increases among women in 
lower socioeconomic groups.\11\ This is further impacted by 
intersections of gender, income, and race/ethnicity contributing to 
multiple inherited disparities as a result of our current system. It is 
our policies, programs, and practices that are contributory to these 
outcomes and our strategies require us to be culturally competent, 
intentional, and actionable to address underlying impacts at their 
core, through policy and legislation. We can no longer afford to seek 
temporary programs and initiatives that address issues without 
substantial change to the policies and practices that have created 
these inequities.
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    \11\ Center for Disaster Philanthropy [CDP] (2022). Women and girls 
in disaster. CDP. Women and Girls in Disasters--Center for Disaster 
Philanthropy.
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    Future approaches require us to invest within our communities and 
put our communities at the forefront of our work as emergency managers 
and public servants. Supporting underserved communities in emergency 
management requires us to focus beyond a broken system and find new 
approaches for emergency management that focus on community investment, 
community revitalization, and community engagement. Our policies should 
be people-centric and focused on what can be achieved within the 
context of our current structure and where we can improve upon 
structurally to eliminate inequities. To highlight opportunities for 
emergency management to more strongly support underserved communities, 
I-DIEM offers the following recommendations.
                            recommendations
   Incorporate policy to integrate community-based support in 
        Federal funding strategies.--Funding, including Federal 
        assistance grants, programs, and contracts, must incorporate 
        policies and procedures that support communities. Funding 
        strategies should be developed that allocates funding directly 
        to communities. These approaches can include percent-based 
        community allocation initiatives, subcontracting initiatives 
        for local businesses and contractors, and requirements for 
        community-based participatory approaches for funding receipt.
   Funding for nonprofit and community-based organizations.--
        Initiatives should be developed that support direct funding for 
        on-the-ground organizations, nonprofits, and community-based 
        organizations that work directly with the communities on 
        mitigation, preparedness, response, recovery, and resilience.
   Sustainability measures for equity initiatives.--Key best 
        practices and appointment advisors should be indoctrinated into 
        current policies to ensure sustainability of equity and 
        community-support measures.
   Prioritized funding streams and accountability.--
        Incorporation of policies and procedures that prioritize 
        community funding streams and holds State and local governments 
        accountable for ensuring that funding matches target 
        communities.
   Improved vulnerability assessments and community profiles.--
        Expand research to include key data on demographics and 
        community profiles allowing all funding support and initiatives 
        to align with target communities and holding all funders 
        accountable for ensuring equity in transaction.
   Incorporate training for emergency management workforce on 
        cultural competency and trauma-informed community engagement 
        strategies.--Incorporate training on cultural competency and 
        trauma-informed community engagement to improve relationships 
        between underserved communities and government.
   Promote efforts to increase diversity within the field of 
        emergency management.--This should include an analysis of the 
        emergency management profession in comparison to the greater 
        community with the understanding that lack of diversity, 
        equity, and inclusion promotes inequitable emergency management 
        policies and programs on Federal, State, and local levels and 
        within the private and nonprofit sectors.
   Expand and sustain whole-community approaches.--Identify, 
        develop, and implement initiatives within the whole-community 
        approach to advocate expansion of whole-community support 
        initiatives with a prioritization for vulnerable, underserved, 
        and marginalized communities.
   Improved pre-planning for community dynamic needs.--Improve 
        pre-planning requirements for community-based mitigation and 
        preparedness that incorporates community profiles, target 
        areas, and tailored approaches to sustainability.
   Take action via legislation and budget authority including 
        FEMA and other Federal agencies with disaster response and 
        recovery responsibilities to integrate equity into programs and 
        policies.
                            closing remarks
    Supporting underserved communities is the responsibility of 
Government and an inherited right of United States citizens across the 
Nation. It is imperative that we focus on new ways to practice 
emergency management that are ground-up, and community-driven providing 
the necessary support and investment into communities. Through this 
approach, underserved communities are empowered to become stewards of 
their own resilience and maintain the necessary engagement mechanisms 
to facilitate impactful change with the support of Government. As an 
organization, we applaud Congressman Thompson and the House of 
Representatives for the introduction and passing of the FEMA Equity Act 
which supports FEMA in its efforts at instilling equity as a foundation 
of emergency management. Further, we recognize the current 
administrator's efforts to instill equity as a priority in FEMA 
policies, programs, and procedures. These actions represent a key 
example of how we, as policy makers and emergency managers, can do 
disasters differently. They represent a focus on humanity and the 
empowerment of our communities. As the leader in disaster equity, I-
DIEM recognizes that there is still work to be done, but a coordinated 
approach yields substantial impacts for our Nation's most underserved 
communities. As disasters continue to exacerbate disproportionate 
burdens, equity-focused policy and approaches are the cornerstone of a 
more resilient future.

    Mr. Payne. Thank you for your testimony. I now recognize 
Mr. Preston Bowlin to summarize his statement for 5 minutes.

  STATEMENT OF PRESTON BOWLIN, EMERGENCY MANAGEMENT DIRECTOR, 
          EMERGENCY MANAGEMENT DIVISION, MARION COUNTY

    Mr. Bowlin. Good morning, Mr. Chair Payne, Ranking Member 
Cammack, and Members. My name is Preston Bowlin, emergency 
management director, Marion County Sheriff's Office. I have 
been a public servant for over 30 years in the fire service as 
a paramedic firefighter and a sworn law enforcement officer 
responding to catastrophic disasters within the State of 
Florida and across State lines. I am privileged to come to the 
Capitol to testify and share experiences and concerns from 
Marion County, Florida counties, and throughout the Nation 
through lessons learned and to discuss preparedness for our 
citizens.
    I have prepared four written testimonies provided to you 
that have an impact on rural counties that affect our citizens 
to prepare and recover in catastrophic events. The first one is 
weather radar coverage; No. 2, emergency short-term and long-
term housing; No. 3, bidirectional amplifier antennas in 
schools, hospitals, and large industrial structures; and No. 4, 
redundant prime communication towers. Due to time constraints, 
my verbal testimony and opening will concentrate on two: 
Weather radar coverage and emergency short-term and long-term 
housing.
    The first one, weather radar coverage. The National Weather 
Service activates the Emergency Alert System most frequently 
for imminent and dangerous weather conditions, severe weather 
storms, and tornadoes. The National Weather Service uses the 
NOAA Weather Radio as its primary means to activate the 
Emergency Alert System. When watches and warnings are issued by 
the National Weather Service, it triggers alert messages for 
local authorities. Having the right data at the right time is 
critical to emergency managers so we can make informed 
decisions and protect our communities before, during, and after 
a severe weather event.
    Currently, rural parts of North Central Florida contain 
dead zones, or zones where tornadoes may not be detected on 
radar. This has been formally acknowledged by the National 
Weather Service. The dead zone where tornadoes may not be 
detected on radar is covering a part of North Central Florida 
that has been hit with destructive tornadoes in the past 
without warning.
    When the radars were initially established, they were 
positioned in areas that were already or were anticipated to 
become densely-populated areas. The current radar 
infrastructure and lack of new radars in fast-growing parts of 
our country, can and has prevented more rural counties and 
communities from receiving timely warning and notifications. 
These areas tend to consist of thousands of modular homes and 
large migrant worker populations that rely on the weather radio 
to provide them with timely warning. Marion County, Florida's 
fifth-largest county in the State of Florida, is home to over 
33,000 modular homes and a large elderly population. Our rural 
jurisdictions are confronted with these unique challenges, and 
we must ensure our communities are equipped with the tools and 
infrastructure needed to ensure that the critical life-saving 
emergency notifications reach everyone they are intended for.
    On March 12, 2022, Marion County, Florida experienced an 
EF-1 tornado that went undetected on radar. Because of that, no 
tornado warnings were issued by the National Weather Service, 
which in turn, did not trigger our local Alert Marion emergency 
notification system. As a result of this tornado, 184 families 
had to be relocated in one apartment complex alone and 259 
residential structures affected.
    Within the past 2 years, Marion County, Florida has 
experienced three confirmed tornadoes that were undetected on 
radar; therefore, no warnings were issued. Due to the distance 
of the county to the closest national weather radar, tornadoes 
are hard to detect below 10,000 feet. There is a critical need 
of additional Federal weather radar coverage in North Central 
Florida.
    The second one is emergency short-term and long-term 
housing. Community resilience has become a critical focus for 
emergency managers and policy makers concerned about disaster 
risk and vulnerability in rural areas. Following a disaster, 
finding a permanent housing solution for low-income and 
underserved households may be especially difficult during a 
housing shortage. Available housing in many high-tourist and 
high-income areas may be out of the acceptable rental range for 
low-income households because they lack the financial resources 
to begin rehabilitation, reconstruction, or obtain permanent 
housing. During this time, provisions for basic human needs, 
food, water, and supplies for sanitation and shelter, may be in 
short supply or unavailable.
    Following the tornado that took place on March 12, 2022, in 
Marion County, Florida, dozens of residents were instantly 
without housing. Homes were destroyed and an apartment complex 
was partially condemned. During these times of rising rent 
pricing and the very limited availability of homes in the State 
of Florida, securing temporary housing both short-term and 
long-term possesses a critical challenge.
    The average rent in Marion County, Florida is between 
$1,500 and $1,700, so when families are faced with being 
displaced, producing first, last, and the security deposits, 
along with moving, transportation, and utilities, can be 
impossible. The State of Florida has a housing contract, but it 
would require a block grant by FEMA that allows most 
flexibility for State and counties. The FEMA individual 
assistance declaration process is flawed. The current 
mechanisms in place are specifically geared to areas with 
denser population. Rural counties are usually holistically 
lower incomes and less tax base versus a dense population with 
sporadic lower incomes and a significant higher tax base.
    While locally we work with partners such as the American 
Red Cross and United Way to assist with immediate needs, we 
find there should be an individual assistance declaration 
process designed for rural, lower-income, lower-tax-base 
communities. FEMA should have a swifter process in place to 
assist the State's Division of Emergency Management to assist 
with emergency housing during State and local declared 
emergencies and local events.
    In closing, I thank you for this opportunity to testify 
before this committee.
    [The prepared statement of Mr. Bowlin follows:]
                  Prepared Statement of Preston Bowlin
    Good morning, Madam Chair Demings, Ranking Member Cammack, and 
committee Members, my name is Preston Bowlin, director of emergency 
management, Marion County Sheriff's Office. I've been a public servant 
for over 30 years in the fire service as a paramedic firefighter and a 
sworn law enforcement officer responding to catastrophic disasters 
within the State of Florida and across State lines. I am privileged to 
come to the Capitol to testify and share experiences and concerns from 
Marion County, Florida counties and throughout the Nation, through 
lessons learned and to discuss preparedness for our citizens.
    Now as an emergency manager for the fifth largest county in the 
State of Florida here are four concerns that have an impact on rural 
and underserved counties that affect our citizens to prepare and 
recover from catastrophic events.
    1. Redundant Prime Communication Towers
    2. Bi-Directional Amplifier Antennas in Schools, Hospitals, and 
        Large Industrial Commercial Structures.
    3. National Weather Radar Sites
    4. Short- & Long-Term Housing Plans for Disasters.
                1. redundant prime communication towers
    Background: triggered by the tragedy of September 11, Marion 
County, Florida's Board of County Commissioners authorized the 
replacement of the public safety radio system in 2005. Approximately 5 
years later, in 2010, the radio system was upgraded to add capacity for 
additional critical partners and agencies. This same system is 
implemented in more than 50 counties in Florida and throughout the 
Nation.
    P25 was formed in 1990 in an agreement among the Association of 
Public-Safety Communications Officials (APCO), the National Association 
of State Technology Directors (NASTD), and agencies of the U.S. Federal 
Government. Marion County was the first county in Florida to implement 
a Project 25 7/800 MHz radio system to create a unique user-driven 
process of working with equipment manufacturers to establish wireless 
land mobile radio (LMR) communication standards that meet the 
requirements of the public safety community.
    Following the terrorist attacks on 9/11, P25 took on a more 
immediate significance as the need for reliable, interoperable 
emergency communications was apparent. SAFECOM, a joint venture of the 
Federal Emergency Management Agency (FEMA) and then newly-formed 
Department of Homeland Security (DHS), was established specifically to 
improve interoperable communications within the public safety 
community.
    The Marion County P25 700/800 MHz radio system is the county's most 
critical infrastructure comprising of 10 radio towers and a master 
site. Due to the advantages provided by its central location with the 
State of Florida, Marion County serves as an ample nexus point for 
logistics and planning. More than 40 government departments and 
divisions, municipal law enforcement, fire rescue, and emergency 
medical services departments, area hospitals, an airport, and the 
public safety agencies of neighboring counties rely on the radio system 
for the emergency operations they conduct. Marion County's chief 
stakeholders are the citizens and visitors who travel through its 
borders, public safety agencies, municipalities, and neighboring 
counties. The current radio system serves the several municipalities 
and partner agencies.
    There is a significant threat that has persisted for Marion County, 
as with others. Historically, counties have developed in self-imposed 
siloes. However, due to increased communicativeness and intentional 
interoperability developed through mutual-aid agreements between 
contiguous counties, a common single point of failure in the respective 
emergency communications infrastructures has become known: the lack of 
prime tower site redundancy.
    A geo-diverse redundant prime site will provide increased 
resiliency and reliability of the radio system. This consideration is 
essential due to population density increases across the county as well 
as an increase in the tornadic activity in the area, the redundant 
prime site project will provide additional coverage to the areas 
proximal to it and increase the reliability of the radio system which 
has a goal of 95 percent system availability.
    On February 07, 2007, a catastrophe befell a neighboring county 
when a tornado struck their radio system prime site, just 1,500-foot 
radio tower and destroyed mission-critical area communications 
equipment.
    In the past 18 months, three tornadoes have made landfall in Marion 
County. On March 12, 2022, the third of three tornadoes touched down on 
a major thoroughfare and proceeded in the direction of Marion County's 
prime site, and just barely missed it. If any of the three tornadoes 
were to strike the Marion County prime site, the entire county--both 
county operations and those of the Ocala Police Department--would go 
comms dark. It's not a matter of IF it will happen, it's a matter of 
WHEN, and a matter of WILL we be prepared.
    To remedy the situation, and assure that communications remain 
reliable for the operations, counties must have the funds and support 
from our local, State, and Federal agencies to ensure that public 
safety communications have redundant prime towers in case of man-made 
or natural catastrophic events impacting our rural communities. An 
approximate cost for a rural county our size is $5 million current-day 
pricing.
 2. bi-directional amplifier antennas in schools, hospitals, and large 
                    industrial commercial structures
    Understanding public safety communication is crucial. With so many 
unfortunate events happening in our schools and hospitals, police and 
firefighters must be able to communicate with each other once they 
enter these school buildings. We need a reliable emergency 
communications system installed in these facilities can keep students, 
staff members, and first responders safe. These facilities are solid 
structures with poured concrete walls and full of steel that make 
communications for especially 800 MHz sometimes impossible to 
communicate with each other or to contact our communication centers.
    A BDA (Bi-directional Amplifier) system is an in-building 
communication system that brings wireless signals into the structure 
from outside, amplifies those signals with a signal booster, and then 
evenly distributes the amplified signals to our two-way radio service 
via an antenna system. This ensures that our first responders can 
maintain wireless communications within a building during medical 
emergencies, fires, natural disasters, active shooter, and other 
events.
    Marion County has experienced this first-hand like many other 
Florida counties responding to emergencies at schools and hospitals and 
were not able to communicate within our own agency, our communication 
center, and not to mention mutual-aid responders during an active-
shooter event at a local high school.
    Requirements must be made on a State and National level to ensure 
that all schools, hospitals, and large commercial structures be 
required to have adequate radio strengths for all first responders 
responding to life threat incidents. For a rural county our size the 
cost of a retrofit project for 50 schools is at an approximate cost of 
$8-12 million. Counties would benefit from assistance from the State 
and Federal Government for implementation.
  3. weather radar coverage--severe weather forecasting and emergency 
                                warnings
    The National Weather Service activates the Emergency Alert System 
(EAS) most frequently for imminent and dangerous weather conditions 
like flash flooding, severe thunderstorms, and tornadoes including 
watches and warnings. The National Weather Service uses the NOAA 
Weather Radio (NWR) as its primary means to activate the Emergency 
Alert System (EAS). The Emergency Alert System (EAS) is also activated 
to enable State and local authorities to communicate important weather 
messages including warnings and watches. When watches and warnings are 
issued by the National Weather Service it triggers alert messages for 
local authorities. Weather data is the critical piece to every weather 
forecast. Having the right data at the right time is critical to 
emergency managers so we can make informed decisions and protect our 
communities before, during, and after a severe weather event.
    Tornadoes and flash floods are two of nature's most violent events, 
sometimes leaving incredible damage and casualties in their path. 
Weather radars are the most important source of information for 
detecting heavy rainfall, but in poor radar coverage can inhibit 
forecasters from making critical warning decisions. Using these radars, 
forecasters can spot the existence of a tornado by detecting airborne 
debris lofted by the twister's circulation. Warning accuracy for weaker 
tornadoes, between EF-0 and EF-2 intensity, as well as flash flood 
warning performance, for areas that are farther from a radar site is 
significantly compromised.
    Currently rural parts of north central Florida contain ``dead 
zones,'' or zones where tornadoes may not be detected on radar. This 
has been formally acknowledged by the National Weather Service. The 
dead zone, where tornadoes may not be detected on radar, is covering a 
part of north central Florida that has been hit with destructive 
tornadoes in the past. The greater distance a location is from a radar 
site, the higher in the sky the radar scans for trouble.
    When the radars were initially established, they were positioned in 
areas that were already or were anticipated to become densely-populated 
areas. The current radar infrastructure and lack of new radars in fast-
growing parts of our country, can and has prevented more rural 
communities from receiving timely warning and notifications. These 
areas tend to consist of thousands of modular homes and large migrant 
worker populations that rely on the weather radio to provide them with 
timely warning. Marion County, Florida the 5th-largest county in the 
State of Florida is home to over 33,000 modular homes and a large 
elderly population. Our rural jurisdictions are confronted with these 
unique challenges, and we must ensure our communities are equipped with 
the tools and infrastructure needed to ensure that critical life-saving 
emergency notifications reach everyone they are intended for.
    On March 12, 2022, Marion County, FL experienced an EF-1 tornado 
that went undetected on radar. Because of that, no tornado warnings 
were issued by the National Weather Service which in turn did not 
trigger our local AlertMarion emergency notification system. As a 
result of this tornado, 184 families had to be relocated in one 
apartment complex alone and 259 residential structures affected. Within 
the past 2 years, Marion County, Florida has experienced 3 confirmed 
tornados that went undetected on radar; therefore, no warnings were 
issued. In Sumter County, Florida, where The Villages' population 
continues to boom, they rely on a Tampa area radar, which again, is too 
far to pick up all the action on the ground. Due to the distance of our 
county to the closest NWS radar tornadoes are hard to detect below 
10,000 feet. In conclusion, there is a critical need for more robust 
and additional Federal weather radar coverage in north central Florida. 
A partnership with rural populations and consideration of rural 
circumstances in preparing for emergencies will ensure that emergency 
preparedness is adequately addressed in some of the most vulnerable and 
underserved communities in the country.
             4. emergency short-term and long-term housing
    Community resilience has become a critical focus for emergency 
managers and policy makers concerned about disaster risk and 
vulnerability in rural areas. Following a disaster, finding a permanent 
housing solution for low-income and underserved households may be 
especially difficult during a housing shortage. Available housing in 
many high-tourist and high-income areas may be out of the acceptable 
rental range for low-income households because they lack the financial 
resources to begin rehabilitation, reconstruction, or to obtain 
permanent housing. During this time, provisions for basic human needs 
(food, water, and supplies for sanitation and shelter) may be in short 
supply or unavailable. Transportation routes may be blocked for days or 
weeks.
    Following the tornado that took place on March 12, 2022, in Marion 
County, Florida dozens of residents were instantly without housing. 
Homes were destroyed and an apartment complex was partially condemned. 
During these times of rising rent pricing and the very limited 
availability of homes in the State of Florida, securing temporary 
housing both short-term and long-term poses a critical challenge. The 
average rent in Marion County, Florida is between $1,500-1,700 dollars, 
so when families are faced with being displaced, producing first, last, 
and the security deposits along with moving, transportation, utilities 
can be impossible. With additional costs of the State of Florida has a 
housing contract, but it would require a block grant by FEMA that 
allows most flexibility for State and counties. The FEMA Individual 
Assistance (IA) declaration process is flawed. The current mechanisms 
in place are specifically geared to areas with denser populations. 
Rural counties are usually, holistically, lower incomes and less tax 
base versus a dense population with sporadic lower incomes and a 
significantly higher tax base. While locally we work with our partners 
such as The American Red Cross and United Way to assist with immediate 
needs, we find there should be an Individual Assistance (IA) 
declaration process designed for rural, lower-income, lower-tax-base 
communities. FEMA should have a swifter process in place to assist the 
State's Division of Emergency Management to assist with emergency 
housing during State-declared emergencies and local events.

    Mr. Payne. Thank you for your testimony. I want to thank 
all the witnesses for their testimony. I will remind each 
Member that he or she will have 5 minutes to question the 
witnesses. I will now recognize myself for questions.
    Let's see. Ms. Ammirati, as I mentioned earlier, in June my 
legislation, the Homeland Security for Children Act was signed 
into law by President Biden. This law authorized a children's 
technical expert will ensure children's needs are incorporated 
throughout the Department of Homeland Security's policies. 
Moving forward, what steps can FEMA take to ensure the 
meaningful implementation of this legislation?
    Ms. Ammirati. Thank you so much and first and foremost, 
thank you for pushing this forward. I think that the tremendous 
strides have been made and the policies and processes that you 
reference are wonderful. They must be operationalized and they 
must be operationalized from Federal, to State, to local, to 
the Tribal, to the communities. Each of our colleagues, and 
associates, and peers on the call have mentioned how important 
that is.
    So, specific funding for them to operationalize those, to 
have the advisor really do a deep dive on studies to ensure 
that they understand who is being impacted. What is the effect 
of having schools closed on children? What is the effect of 
having children isolated should they be sheltered? I think 
those are our main responses to that. But a huge thank you for 
pushing it forward.
    Mr. Payne. Thank you very much. Let's see. Ms. Bottcher and 
Mr. Richards, whether someone is rich or poor influences how 
someone fares during a disaster. For example, families with 
cars who can afford gas and a place to stay will be more likely 
to evacuate than those who do not have those resources. Ms. 
Bottcher and Mr. Richards, how can State, local, and Federal 
Governments help low-income communities and older adults who 
are often living on fixed incomes to ensure that income levels 
do not determine disaster outcomes? Ms. Bottcher first.
    Ms. Bottcher. Thank you, Mr. Chairman. I would say that 
meeting people where they are and providing them transportation 
options is the best way to get people out of harm's way if an 
evacuation is called. To do that can be very difficult with 
those particularly older adults with physical limitations. So, 
in Louisiana, we have several parishes that have a registry 
where older adults with disabilities or physical limitations 
can actually register so that local authorities know where they 
live and what their needs are so that we can be better prepared 
to get them out of harm's way.
    Mr. Payne. Thank you. Mr. Richards.
    Mr. Richards. Excellent, thank you for this question. I 
think it is really important to understand, as mentioned 
earlier during the summary testimony, that we do disasters 
differently. We have to understand the communities that we 
serve, where those vulnerabilities exist, those social 
determinants of health, right? We have to really engage with 
communities.
    So, when we look at it at a local and a State level, each 
level should be informing where those communities exist. They 
should understand what the dynamics of those communities are. 
They should understand how to best serve those communities. 
Include those communities in their process to understand their 
needs. This will help frame the policies that we put in place 
for the programs that are developed to focus on these 
populations to meet the needs of these populations to truly 
understand what it is they need and how to best facilitate 
those needs for them in the most efficient and effective 
manner.
    So, I believe that the first step is truly in engaging with 
the communities. But then also, coordinating between the local, 
the State, and the Federal Government to expound upon that 
engagement and truly understand. But I as mentioned before, we 
meet the community where they are, we understand their issues, 
and then we take that and we use that community-based 
participatory research, what we have learned, those 
experiences, to develop programs and initiatives that could 
make a big difference. Thanks.
    Mr. Payne. Thank you. I agree, we know where these 
communities are. They are identified. So, we need to bring the 
resources to them instead of being--need to be proactive in 
that effort. So, thank the both of you. I will now recognize 
the Ranking Member, Mrs. Cammack, for 5 minutes.
    Mrs. Cammack. Thank you, Mr. Chairman. Director Bowlin, it 
is my understanding that Marion County operates and maintains a 
registry of individuals who may need additional assistance 
during a disaster. How does this work? Do individuals have to 
qualify? Is there a criteria? How do they register? Who is 
responsible for maintaining this registry? Then how is it 
utilized in an emergency situation?
    Mr. Bowlin. Yes, we do have a special needs registry. The 
initial responsibility is out of my Office of Emergency 
Management but we work very close with our Department of 
Health. So, those applications come into our office; therefore, 
we put them on our registry. There are various questions that 
are screened, not only medically through the Health Department 
for their needs medically, but also whether or not they need 
transportation.
    One of the things we realized is a lot of those with 
special needs do have pets. So, if we do not have pet-friendly 
shelters that they can take their pets with them, they will not 
go to shelters. So, we do have pet-friendly shelters at our 
special needs shelters for them to be able to assist them with 
that as well.
    So, those with other service animals, you know, we are able 
to accommodate. We have some that are not able to go our 
special needs shelters due to other medical concerns that we 
could not handle in a shelter. So, we are working with our 
nursing homes, our hospitals, to make sure transportation, not 
only to our special needs shelters, but also to hospitals. This 
is all vetted twice a year through the special needs registry.
    Mrs. Cammack. How many people are on the registry 
currently?
    Mr. Bowlin. We currently have between 675 and 700 special 
needs registry clients. One of the things we recognize right 
before storms,----
    Mrs. Cammack. Mm-hmm.
    Mr. Bowlin [continuing]. We will starting getting, our 
office will get lit up with calls, people trying to get on last 
minute, you know, sometimes 100, 150, trying to get on the 
registry.
    Mrs. Cammack. Now, I know that your written testimony 
concerns two other areas that you weren't able to summarize in 
your opening remarks. We have had several conversations about 
shelters, buildings, public spaces, and active-shooter threats, 
and the need for emergency communications and why that is so 
important. Can you elaborate?
    Mr. Bowlin. Quickly, redundant prime communication towers 
is a big thing, not only in Marion County, but in other Florida 
counties and throughout the Nation, is a lot of agencies and 
especially after September 11, with an enhancement of public 
safety communication radios. We did go to the P25 system and 
upgraded because all our agencies in Marion County are on one 
prime tower. We have seen the need through the State of Florida 
as many counties do not have a redundant tower. So, if that 
tower goes down, and we did have a situation back in 2007 in a 
neighboring county where a tornado hit their prime tower, which 
caused catastrophic communication issues, is the need for 
counties to work together even with redundancy for financially 
to be able to share these prime towers, or redundant towers, so 
if a system goes down, we could have a secondary tower. Again, 
this is something that is not just new to Marion County, but 
nation-wide, and we need that.
    The second is bi-directional amplifier antennas in schools, 
hospitals, and large industrial commercial areas. As a public 
safety person, I personally have experienced this responding to 
emergencies in schools and hospitals. We too, in Marion County 
have had a school shooting. We have had a hospital shooting.
    Responding for public safety, going into there, these 
structures are concrete and steel. Communications is poor. We 
know this. We have experienced it. We really need to work with 
bi-directional antennas in these facilities, these critical 
facilities, to keep our students safe, keep our staff safe, and 
first responders responding to these locations in emergencies. 
To be able to put these in to be able to broadcast our 
communications not only to responders, but also be able to get 
that information back to our communications centers. It is 
almost impossible in a lot of these facilities and we are 
seeing this Nation-wide, you know, in the news daily, and it is 
of concern Nation-wide.
    Mrs. Cammack. So, in the last 30 seconds that we have left, 
I would like to give you the floor just to talk about how FEMA 
can be better in terms of responding to some of these 
emergencies, for example, these undetected tornadoes that are 
tearing through, they create havoc and chaos, but it doesn't 
trigger a FEMA response. But this is an underserved community, 
so, how do you recommend that FEMA go forward?
    Mr. Bowlin. So, that is----
    Mr. Payne. In 8 seconds.
    Mr. Bowlin. All right. Radar, we are so far from the 
National Weather Service in Jacksonville and Tampa. As radar 
comes over Marion County, it does not detect anything under 
10,000 feet. There is short coverage there. The National 
Weather Service puts a meteorologist in our EOC during tropical 
storms because the coverage is not sufficient for Central 
Florida, Marion County, Sumpter County. There are a few 
counties in there that share the same concerns. Thank you.
    Mrs. Cammack. Thank you. I yield back.
    Mr. Payne. Thank you. I now recognize Mrs. Watson Coleman 
for 5 minutes.
    Mrs. Watson Coleman. Thank you, Mr. Chairman, and I want to 
thank all the witnesses. Your testimony has been very helpful 
for me to understand what you are experiencing and I want to 
know how FEMA can do better for those constituents that you all 
represent here.
    Ms. Bottcher, and Ms. Ammirati, and Mr. Richards, in my 
district and across the Nation, we are seeing historic heat 
waves. I introduced a bill, H.R. 7949, the Stay Cool Act, to 
address the threat of extreme heat. As we see these increased 
incidences of the extreme heat, how should the Federal 
Government account for the unique needs of vulnerable 
communities, including older adults, children, individuals with 
disabilities, and of course, low-income residents? What is it 
that we should be doing, that FEMA should be doing in these 
areas? Ms. Bottcher.
    Ms. Bottcher. Yes, thank you so much----
    Mrs. Watson Coleman. Ms. Ammirati and----
    Ms. Bottcher [continuing]. For the question.
    Mrs. Watson Coleman [continuing]. Mr. Richards, yes.
    Ms. Bottcher. As I stated in my testimony, heat was the 
biggest threat to older adults after Hurricane Ida where it was 
incredibly hot and humid. I would say that we--having the 
reliable systems. That is first and foremost is to invest in 
our infrastructure so that we have reliable systems that we can 
count on. In the event that we cannot, we have to have the 
ability to have cooling centers within communities, to be able 
to point people in the right direction of where those centers 
are.
    In fact, in New Orleans right now, they are investing a lot 
of dollars into libraries, senior centers, community centers, 
rec centers, to have generator power in the event that the 
entire city is in a blackout so that they can have cooling 
centers to prevent those heat-related illnesses and deaths. 
Thank you.
    Mrs. Watson Coleman. Thank you. Ms. Ammirati and Mr. 
Richards, do you have anything you would like to contribute to 
that?
    Ms. Ammirati. Sure, thank you so much. I would say that 
children are particularly susceptible to dehydration more so 
than older teens and adults because they have smaller bodies. 
They have smaller reserves of water and they have more body 
surface per pound of weight. So, anyone can become dehydrated 
and but infants and children are the most likely group to 
experience severe diarrhea, vomiting, and are especially 
vulnerable to dehydration.
    In low-income communities, we know that they have less 
access to safe green space, community water features, pools, 
sprinklers, parks, et cetera. Importantly, with regard to 
education and learning, old school buildings, to my colleague's 
reference to infrastructure, that don't have appropriate 
cooling systems, which lead to learning loss.
    So, a study by the Government Accountability Office found 
that about 41 percent of public-school districts in the United 
States need to update or replace the heating, cooling, and 
ventilation systems in at least half of their schools. That 
represents about 36,000 schools Nation-wide.
    Mrs. Watson Coleman. Thank you.
    Ms. Ammirati. You are welcome.
    Mrs. Watson Coleman. Mr. Richards, do you have anything you 
want to contribute to that? If not, I have another question for 
you.
    Mr. Richards. Absolutely. I want to definitely take the 
time to contribute just in saying that community assessments 
here are important, understanding the community. There are 
intersections between heat and chronic disease, heat and age, 
and all of those things. So, understanding the community, 
assessing the community, and identifying those community needs 
ahead of time make a big difference.
    When we can understand those needs ahead of time, that 
allows us to better pre-identify the resources that are needed 
for those vulnerable populations. It allows us to make sure 
that we have the tools already in place. Heat is not a new 
issue, but it is one that is rising and it is one that we 
should intentionally raise awareness to and continue to focus 
on how we can better mitigate that.
    Mrs. Watson Coleman. Yes. For all of you, Mr. Bowser thank 
you for your testimony--Mr. Bowlin, I am sorry. For all of you, 
do you all interact with sort-of a national network who address 
the same constituents that you do in terms of issues of this 
nature? That is No. 1. No. 2, what do you think is FEMA's 
greatest fault in redressing those needs of individuals and 
communities in the sort-of poor income districts or 
communities?
    Mr. Payne. In 2 seconds.
    Mrs. Watson Coleman. I will start with you, Mr. Richards. 
Oh, geez. Maybe I will yield for a second.
    Mr. Payne. Yes, if the gentlelady would yield. We do have 
time to go around----
    Mrs. Watson Coleman. You got it.
    Mr. Payne [continuing]. For a second round of questioning.
    Mrs. Watson Coleman. Thank you, Mr. Chairman.
    Mr. Payne. So, thank you for yielding. I will now recognize 
myself for a second round.
    Mr. Richards and Ms. Roth, under the Biden administration, 
FEMA has set forth goals to increase diversity among its work 
force. Mr. Richards and Ms. Roth, what can FEMA do to prepare 
its work force to deal with the diverse needs of underserved 
communities? We will go with Ms. Roth first.
    Ms. Roth. Thank you, Chairman, for that question. So, FEMA 
since 2017, has had several GAO, Government Accountability 
Office, open and closed recommendations focusing on training. 
Those have not been fulfilled and that training is focused on 
both the work force and the community and the need for 
inclusion and, you know, diversity, inclusion, and 
accessibility.
    When I left FEMA in 2017, they were on their way to a work 
force of 285 disability experts. Unfortunately, most of those 
folks are no longer there. So, as they are focusing on 
rebuilding the work force, it is going to be imperative that 
they focus on rebuilding the expertise to serve multiply-
marginalized disabled people.
    Mr. Payne. Thank you. Thank you. Mr. Richards.
    Mr. Richards. Excellent, thank you for this question. You 
know, I think that there has to be intentionality behind 
everything that we do. One of the ways that I think this could 
be done, of course, is through diversifying the work force. The 
work force and the leadership in FEMA have to be representative 
of the communities that we serve. They have to be inclusive of 
the communities that we serve.
    There is a bit of a disconnect, you know, between the 
communities and then the Federal Government, whether it is lack 
of trust or just issues and barriers that are in place. I think 
connecting more with those communities has got to be imperative 
but then also, diversifying a work force that can facilitate 
those connections.
    There also needs to be improvements in training in terms of 
culturally-competent training and how we identify with those 
communities. How we engage communities. So, community 
engagement. Informed community engagement to that matter too.
    A lot of these communities have gone through trauma. They 
are going through vulnerabilities. They are going through 
experiences. Knowing how to address those experiences is as 
much of a mental issue, as it is a, I am doing my job as an 
emergency management professional issue, right? So, that mixed 
with cultural competence would be a huge help.
    Then I also think there has to be ways to improve some 
pipeline opportunities into employment whether it is for 
younger individuals that are seeing emergency management, 
seeing leaders that look like them, that are familiar with 
them, that they can identify with, that is another way that 
they can focus on intentionally creating opportunities to 
diversify the work force.
    Mr. Payne. Thank you. Let's see. Continuing on that, let's 
see, this is for Mr. Richards, Ms. Roth, Ms. Ammirati, and Ms. 
Bottcher. Extreme weather events are causing millions, 
especially in the underserved community, to lose their homes 
and so much more. In recent years, we have seen historic 
flooding, record-breaking hurricanes, and wildfire seasons. Mr. 
Richards and Ms. Roth, what actions should FEMA take to help 
the underserved communities that are adversely impacted by 
climate change? Quickly. Ms. Roth.
    Ms. Roth. Very simply, they need to work with the community 
leaders. We have a robust national group led by people with 
disabilities. We welcome involvement with FEMA to work together 
on issues around climate and extreme weather, as well as other 
disasters.
    Mr. Payne. Thank you. Mr. Richards, quickly.
    Mr. Richards. I think it would be important here again to 
focus on the community assessment and understanding the 
community, being able to identify where those issues exist, and 
then working toward that. You know, when we look at kind-of 
State flood plans, 84 percent of State flood plans didn't 
consider how flooding disproportionately affected throughout 
vulnerable populations. There are accountability measures that 
I believe that FEMA can put in place in terms of their funding 
or their approaches in working with State and local governments 
that can also encourage better approaches to how we engage 
communities.
    Mr. Payne. Thank you. Thank you very much. I will now 
recognize the Ranking Member, Mrs. Cammack, for 5 minutes.
    Mrs. Cammack. Thank you, Mr. Chairman. I am going to jump 
over to Ms. Bottcher. You mentioned that AARP regularly leads 
programming through rural free delivery TV to educate your 
members in remote and rural areas about how to better prepare 
for disasters. Can you talk a little bit more about this 
program and just dig into some of the highlights in the release 
that you all just had?
    Ms. Bottcher. Thank you so much, Congresswoman. Yes, so, 
AARP really tries to maintain the state of preparedness. So, 
hurricane season is a season, right? It is June 1 through 
November 31. We are very familiar with that along the coast. 
But I think it is important that we keep that state of 
preparedness year-round for all sorts of emergencies. So, AARP 
State offices and through its rural television program 
continually educates its members about how to stay prepared. 
Those emergency go-bags that we have. What financial documents 
you may need to have at the ready, right? So, that they are 
protected, that you can just grab and go when you need to. I 
mean, all those types of things. Then we help them try to 
navigate recovery that is oftentimes so complex, right? It is 
on-line. We help them get to the right people.
    The other thing I want to add, and Mr. Richards had said 
the word, intentionality. It is so important that we are very 
intentional in this work and that we have collaborative 
partnerships across the board from FEMA to our emergency 
managers, to stakeholders like AARP, Save the Children. It is 
important that we all come together and talk about how best to 
serve these vulnerable communities, how we educate them, and 
how we help them through recovery. Thank you.
    Mrs. Cammack. I appreciate that. Thank you. Director 
Bowlin, AARP is a great example of some of our external 
stakeholders. Can you list out and talk about your relationship 
and how you engage with some of these outside stakeholders? Do 
you work with AARP, for example, in the community?
    Mr. Bowlin. Absolutely. Center of Independent Living, we 
work with AARP. We also working with our county health 
department, you know, a lot of the other programs, you know, 
with our FEMA programs, our community emergency response team 
trainings, and the other not-for-profit organizations, the 
American Red Cross, our county Families and Children's 
Services, to be able to provide education, training, and also 
financial assistance. Then a lot of our faith-based 
organizations to be able to have funding available to educate 
and, you know, provide services throughout the community.
    Mrs. Cammack. Excellent. I know my colleague, Mrs. Watson 
Coleman, she was kind-of alluding to one of the earlier 
questions about best practices. How can FEMA be better in terms 
of working with our local counties and States in executing on 
their mission? So, if Mr. Bowlin, if you can take that and I am 
sure she is going to follow up with some extra time for you as 
well.
    Mr. Bowlin. So, one of the things is, you know, especially, 
you know, during a declared emergency, you know, through the 
State and through FEMA is bringing in assistance and funding to 
be able to come into our rural communities especially for 
housing. Housing is almost impossible in Marion County to find 
after all.
    But one of the things especially on a local level, when 
there is not a declaration and counties do not meet their 
thresholds, that meet the State thresholds for Federal FEMA 
assistance to come in, is being able to provide assistance on a 
local level, you know. This was a big impact for Marion County. 
Over 252 homes, you know, that were lost trying to find 
housing, provide transportation, and everything that kind-of 
goes along with that move.
    So, you know, working with State EM, emergency management 
and local emergency management directors, are in robust 
conversations to ensure that when catastrophic events happen, 
we are prepared to serve the underserved and those in need. One 
of the bigger things, as an example, is on a Federal level 
during COVID, there was the ARPA money, there was the Cares Act 
money. Again, they pushed those down to the State and local 
levels because we know what we need. We need those immediate 
resources, especially with housing, to get these families out 
of the shelters or, you know, out of hotels to be able to get 
back to schools. These are the needs that we see but we don't 
have the funding. The State has housing contracts, but they 
need grant blocks, funding from the Federal Government to go in 
place. When there is not a Federal declaration, those funds and 
those resources are really needed at a local and rural level.
    Mrs. Cammack. Thank you. I yield back.
    Mr. Payne. The gentlelady yields back. I now recognize Mrs. 
Watson Coleman for 5 minutes.
    Mrs. Watson Coleman. Thank you, Mr. Chairman. Mr. Bowlin, 
ask you a question, a declaration is determined based upon the 
cost of the loss during a situation. Is it dollars that 
determines whether or not a declaration is--or is it the amount 
of loss of property? I am trying to understand why in rural 
areas and in low-income areas the declarations don't seem to 
come as quickly as possible. Is it a function of the value that 
is placed on those losses?
    Mr. Bowlin. To be honest with you I am not exactly sure. It 
is just one of the things that, you know, that we have 
experienced, you know, even after Hurricane Irma is bringing in 
those resources of, you know, whether it be the DLOCs or, you 
know, those services to be able to bring in and be able to 
provide those, you know, filling out applications. I know, you 
know, it was pretty quick with especially with the tornadoes 
that came in through Marion County is, you know, having the 
Small Business Association, you know, loans that are available.
    But again, those with lower incomes are the ones that need 
immediate assistance are probably going to be denied those 
resources through SBA. Again, by the time that these services 
are coming in and is being set up to be able to start the 
process, it takes very long periods of time to be able to 
provide that financial assistance on a short-term, you know, 
before they even get to that long-term need.
    Mrs. Watson Coleman. Thank you. With regard to Ms. Roth and 
Mr. Richards, for those individuals who have a multiplicity of 
issues, disability, poor, minority, you know, low-income, all 
that kind of stuff, what do you think is the greatest deficit 
that you experience with FEMA in determining how to make these 
individuals whole and restoring them after a disaster? Ms. Roth 
and then Mr. Richards.
    Ms. Roth. So, for many people, the limits of assistance 
that are available to them mean that they are not going to be 
able, you know, $35,000 max grant, which most people don't ever 
actually receive. Coupled with what many people have talked 
about earlier today, lack of housing. Coupled with the 
complexities that many people face in navigating post-
disasters.
    Mrs. Watson Coleman. So, is it the amount that you are 
eligible for representative of a percentage of your loss? Or is 
that just like a maximum that FEMA would give--if you lost a 
$500,000 home, is FEMA still only going to give you $35,000?
    Ms. Roth. Yes. If you have a $500,000 home, if you have 
homeowner's insurance, if is more than $35,000, you don't get 
anything. Which, is, you know, I mean, we could have a separate 
conversation about that. But the bottom line is that for most 
people, it is those local experts who can help them to navigate 
the resources. Yet, those local disability-led organizations, 
in particular, are not funded and not included in helping 
people to be----
    Mrs. Watson Coleman. Thank you.
    Ms. Roth [continuing]. Able to access resources.
    Mrs. Watson Coleman. I have 1 minute and 3 seconds. Mr. 
Richards, do you want to comment on that in terms of minority 
communities and low-income communities?
    Mr. Richards. Absolutely. You know, the issue there is 
access. So, access to information, access to education, access 
to capacity support to apply for these grants. Knowing how to 
apply for them, knowing where to find the funding. There has to 
be intentional efforts toward these communities that do that. 
That has to come from the top at the Federal level. That also 
has to come at the State level and the local level. There needs 
to be intention about it. Those vulnerability assessments we 
talked about. Understanding the community dynamics, demographic 
analyses, and where those vulnerabilities----
    Mrs. Watson Coleman. Thank you.
    Mr. Richards [continuing]. Exist allow us to really look 
into those things and then better put our resources into.
    Mrs. Watson Coleman. All right. In closing, is FEMA not 
putting the resources necessary into being able to facilitate 
that information on the local level, being shared by people who 
know the communities?
    Mr. Richards. I believe there has to be a better investment 
in communities. Community-based organizations, non-profit.
    Mrs. Watson Coleman. Thank you. I yield back, sir.
    Mr. Payne. The gentlelady yields back. I want to thank the 
witnesses for their testimony, their valuable testimony, and 
the Members for all their questions. The Members of the 
subcommittee may have additional questions for the witnesses. 
We ask that you respond expeditiously in writing to those 
questions.
    The Chair reminds Members that the committee record will 
remain open for 10 business days. Without objection, the 
subcommittee stands adjourned.
    [Whereupon, at 10:15 a.m., the subcommittee was adjourned.]

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