[Senate Hearing 117-136]
[From the U.S. Government Publishing Office]
S. Hrg. 117-136
INCLUSIVE DISASTER MANAGEMENT:
IMPROVING PREPAREDNESS,
RESPONSE, AND RECOVERY
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HEARING
BEFORE THE
SPECIAL COMMITTEE ON AGING
UNITED STATES SENATE
ONE HUNDRED SEVENTEENTH CONGRESS
FIRST SESSION
__________
WASHINGTON, DC
__________
NOVEMBER 18, 2021
__________
Serial No. 117-10
Printed for the use of the Special Committee on Aging
[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]
Available via the World Wide Web: http://www.govinfo.gov
__________
U.S. GOVERNMENT PUBLISHING OFFICE
46-553 PDF WASHINGTON : 2022
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SPECIAL COMMITTEE ON AGING
ROBERT P. CASEY, JR., Pennsylvania, Chairman
KIRSTEN E. GILLIBRAND, New York TIM SCOTT, South Carolina
RICHARD BLUMENTHAL, Connecticut SUSAN M. COLLINS, Maine
ELIZABETH WARREN, Massachusetts RICHARD BURR, North Carolina
JACKY ROSEN, Nevada MARCO RUBIO, Florida
MARK KELLY, Arizona MIKE BRAUN, Indiana
RAPHAEL WARNOCK, Georgia RICK SCOTT, Florida
MIKE LEE, Utah
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Stacy Sanders, Majority Staff Director
Neri Martinez, Minority Staff Director
C O N T E N T S
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Page
Opening Statement of Senator Robert P. Casey, Jr., Chairman...... 1
Opening Statement of Senator Tim Scott, Ranking Member........... 3
PANEL OF WITNESSES
Sue Anne Bell, Ph.D., Assistant Professor, School of Nursing,
University of Michigan, Ann Arbor, Michigan.................... 6
Wanda Spurlock, Ph.D., Professor, College of Nursing and Allied
Health, Southern University and A&M College, Baton Rouge,
Louisiana...................................................... 7
Randy Creamer, Vice Chairman, South Carolina Voluntary
Organizations Active in Disaster (VOAD), Columbia, South
Carolina....................................................... 9
Danielle Koerner, Volunteer Management Coordinator, Delaware
County Department of Emergency Services, Rutledge, Pennsylvania 11
CLOSING STATEMENT
Closing Statement of Senator Tim Scott, Ranking Member........... 30
APPENDIX
Prepared Witness Statements
Sue Anne Bell, Ph.D., Assistant Professor, School of Nursing,
University of Michigan, Ann Arbor, Michigan.................... 35
Wanda Spurlock, Ph.D., Professor, College of Nursing and Allied
Health, Southern University and A&M College, Baton Rouge,
Louisiana...................................................... 43
Randy Creamer, Vice Chairman, South Carolina Voluntary
Organizations Active in Disaster (VOAD), Columbia, South
Carolina....................................................... 52
Danielle Koerner, Volunteer Management Coordinator, Delaware
County Department of Emergency Services, Rutledge, Pennsylvania 54
Questions for the Record
Sue Anne Bell, Ph.D., Assistant Professor, School of Nursing,
University of Michigan, Ann Arbor, Michigan.................... 59
Wanda Spurlock, Ph.D., Professor, College of Nursing and Allied
Health, Southern University and A&M College, Baton Rouge,
Louisiana...................................................... 63
Randy Creamer, Vice Chairman, South Carolina Voluntary
Organizations Active in Disaster (VOAD), Columbia, South
Carolina....................................................... 67
Danielle Koerner, Volunteer Management Coordinator, Delaware
County Department of Emergency Services, Rutledge, Pennsylvania 67
INCLUSIVE DISASTER MANAGEMENT:
IMPROVING PREPAREDNESS,
RESPONSE, AND RECOVERY
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THURSDAY, NOVEMBER 18, 2021
U.S. Senate,
Special Committee on Aging,
Washington, DC.
The Committee met, pursuant to notice, at 9:32 a.m., via
Webex and in room SD-562, Dirksen Senate Office Building, Hon.
Robert P. Casey, Jr., Chairman of the Committee, presiding.
Present: Senators Casey, Gillibrand, Blumenthal, Rosen,
Kelly, Warnock, Tim Scott, Braun, and Rick Scott.
OPENING STATEMENT OF SENATOR
ROBERT P. CASEY, JR., CHAIRMAN
The Chairman. The hearing will come to order. Today's
hearing will examine gaps in disaster management that cause
people with disabilities and older adults to be overlooked.
Whether it is hurricanes or wildfires or the next pandemic,
people with disabilities and older adults must have a seat at
the planning table.
This hearing is particularly timely for a state like
Pennsylvania which has suffered through devastating floods and
tornadoes just this summer, spawned by the remnants of
Hurricane Ida, of a record-setting Atlantic hurricane season,
part of a record-setting hurricane season. This hearing also
comes after more than 190 nations reaffirmed their commitment
to take into account the needs of people with disabilities at
the Glasgow Summit on Climate Change.
People with disabilities and older adults are often the
ones hardest hit by disasters, but they are not given a voice
in the management process. The 2018 Camp Fire in California
serves as a stark reminder of this fact. The Los Angeles Times
reported shortly after that fire that 53 of the 69 deaths--53
of 69 deaths--were to people over the age of 65.
To ensure the safety of people with disabilities and older
adults, they must be included in each phase of disaster
management. That means in the preparation phase, response
phase, the recovery and mitigation efforts that are undertaken.
That is why I have introduced a piece of legislation to
deal with some of these issues. It has got a long name, the
Real Emergency Access for Aging and Disability Inclusion for
Disasters Act, or the REAADI Act, R-E-A-A-D-I, REAADI. This is
Senate Bill 2658.
This bill would ensure that people with disabilities and
older adults have a voice at every stage of disaster
management. It would require accessible information about
planning for disasters, making sure that that information is
available to everyone, including those with disabilities. It
would make sure that shelters and temporary housing are
accessible to older adults and people with disabilities.
It is not only natural disasters we need to be concerned
with. The COVID-19 pandemic has made it clear that disasters
are not limited to weather events. Roughly one quarter of the
760,000 deaths during this pandemic have been in nursing homes
or other long-term care facilities, where most residents are
older adults or people with disabilities.
The bottom line is we must continue to invest in bold
policy solutions to save lives and strengthen communities. The
Build Back Better Bill will include a once-in-a-generation
expansion of home-and community-based services. It is based
upon a bill that I introduced, the Better Care Better Jobs
Bill. What we are trying to do there is to create better jobs
for those who are doing this important work, home-and
community-based services work, better care for seniors and
people with disabilities who are served, and better support for
family caregivers. These investments will mean better
preparation for disasters and emergencies.
Today we will hear testimony how better access to home-and
community-based services can help save lives during a disaster.
We will also hear crucial testimony that people affected by
disasters need to maintain their health care throughout the
response and recovery phases of disaster management.
The Build Back Better legislation and the recently passed
Infrastructure Bill will make historic investments in reducing
the speed and effects of climate change. All of these bills are
a recognition of what the science is telling us, that climate
change is causing natural disasters the likes of which we have
never seen before.
Unprecedented weather, health, and manmade disasters make
it necessary to have a whole-community approach to emergencies.
People with disabilities and older adults must have a seat at
the table when we are doing that planning. As we often hear,
representation matters, and in disability and aging communities
there is an old expression, ``Nothing without us that is about
us.'' ``Nothing about us without us.'' That should hold true
for disaster planning as well.
I want to say to the Ranking Member, Ranking Member Scott,
before I turn to him, I am happy to join you, Senator Scott, on
your bipartisan FEED Act, Senate Bill 19, which would make it
easier for small and mid-sized restaurants to provide
nutritious meals to people during disasters.
Senator Tim Scott. Thank you, Mr. Chairman.
The Chairman. I thank you and thanks for introducing the
bill. With that, I will turn to Ranking Member Scott for his
comments.
OPENING STATEMENT OF SENATOR
TIM SCOTT, RANKING MEMBER
Senator Tim Scott. Thank you, Mr. Chairman, first for your
leadership on this Committee and second for joining the FEED
Act, a very important piece of legislation that will help us
tackle the challenges of food insecurity, especially during the
height of disasters.
Thank you to our witnesses for being with us today.
Older Americans and people with disabilities are more
vulnerable to natural disasters, and we must do everything we
can to protect them.
Mr. Chairman, I recognize how hard Hurricane Ida hit your
State in September and how Pennsylvanians responded as they
always do, with courage and with strength.
The Palmetto State, we are all too familiar with floods,
hurricanes, and other natural disasters. Like so many other
South Carolinians, I will never forget the 1,000-year flood in
2015. After those floods, we were hit the next year by
Hurricane Matthew. We experienced tragedy and triumph.
Folks like Janice and Gene Davis, a wife and husband in
Hilton Head, represent the strength of South Carolinians during
a response to a natural disaster. Gene owned an auto painting
business. Janice was a caregiver to Jo Scott, an 88-year-old
widow. When it became unsafe for Jo to stay home, Janice and
Gene drove through the storm to pick her up. With the power
out, streets flooded, and trees down, they drove Jo to her
son's home in St. Louis, Missouri, more than 800 miles away.
South Carolina has proven a leader in disaster management.
The University of South Carolina's Hazards & Vulnerability
Research Institute developed a tool that estimated a county's
vulnerability to disaster. The tool, the Social Vulnerability
Index, includes elderly persons and individuals with special
needs. The Index now includes all counties in the United
States, and FEMA has adopted in it in their National Risk
Index.
The first step in effective disaster management is, of
course, prevention. That is why I introduced bipartisan
legislation with Senator Schatz, the Repeatedly Flooded
Communities Preparation Act. This seeks to provide more
resources to those areas of our Nation that consistently and
continuously flood. They are flood-prone communities. The
legislation would break the costly cycle of repeated flooding
and building by providing our communities with the tools to
take proactive steps to reduce flood risk and safeguard homes
and businesses.
Even the best preparation cannot stop every disaster. Once
a disaster happens, we also need solutions to assist in those
communities. That is why I introduced the FEED Act with Senator
Murphy from Connecticut. I am very thankful that our Chairman
has joined the FEED Act. The FEED Act would increase food
security for older Americans and others during emergencies by
opening up a pathway for food producers, restaurants, and
nonprofits to partner with their State and local governments to
meet the needs on the ground. It is through reforms like the
FEED Act that we are able to assist local communities in the
midst of a disaster.
Last, we must also continue to work to improve post
disaster recovery. In South Carolina, as in many southern
states, heirs' property is passed down by inheritance. In the
wake of disasters, FEMA regulations have reflected unjust
discrimination against those heirs who are disproportionately
poor and minorities because they simply cannot afford to clean
the titles. Clear the titles. These homeowners have been ruled
ineligible for the disaster assistance they should receive.
This resulted in FEMA denying twice as many requests for
disaster aid in majority minority counties as the national
average.
In August, Senator Ossoff and I sent a letter to Homeland
Security Secretary Mayorkas, urging FEMA to review and revise
its practices. As a result, FEMA changed its policies in
September. FEMA will now accept a broader range of
documentation to prove home ownership and occupancy, such as
receipts for home repairs or improvements, a long overdue
correction of something that was simply not right. I am pleased
with this progress and urge FEMA to do more to better support
people in rural areas.
The poorest homeowners, often in rural America, receive
half of what wealthier homeowners do in home repair assistance.
There is a l7-point gap between the denial of aid for higher
income owners versus poorer homeowners, who tend to live in
rural places like rural South Carolina.
FEMA accepts 90 percent of disaster requests of $7.5
million or more compared to just 6 percent for requests of $1.5
million or less. While damages in more urban areas often easily
reach $10 million, larger amounts of damage in rural areas do
not often meet that total.
I look forward to working with you, Mr. Chairman, as we
look for ways to help our seniors weather the storm and be
better prepared for the outcome that will be positive,
especially for those who are also with special needs and
disabilities. Thank you, Mr. Chairman.
The Chairman. Thank you, Ranking Member Scott.
It is Thursday, because we have got a lot going on, there
will be Senators in and out of this hearing and juggling
hearings. I know the Ranking Member is one of those Senators
having to juggle two big hearings.
We were joined, and have been joined, by Senator Braun of
Indiana, Senator Rosen of Nevada, and Senator Rick Scott of
Florida.
Let me turn now to our witnesses. I will introduce them one
after another before their testimony, but our first witness is
Dr. Sue Anne Bell. Dr. Bell is an assistant professor at the
University of Michigan, where she focuses her research on how
disaster preparedness at the Federal, State, and local levels
can affect individual health outcomes following disasters. She
is also a nurse, scientist, and family nurse practitioner who
has worked on the ground responding recently to Hurricane Maria
and, of course, the COVID-19 pandemic.
Thank you, Dr. Bell, for being with us today and sharing
your expertise with the Committee.
Our second witness is Dr. Wanda Spurlock, a professor in
the College of Nursing and Allied Health and Southern
University and A&M College in Baton Rouge, Louisiana. Dr.
Spurlock recently served as co-chair of a national policy
expert roundtable on emergency preparedness for older adults.
Her research focuses on disaster preparedness, response, and
recovery for older adults, including the role of family
caregivers and skilled nurses in disaster management.
Thank you, Dr. Spurlock, for being with us today and
sharing your expertise with the Committee.
For witness number three, I will turn to Ranking Member
Scott to introduce our next witness.
Senator Tim Scott. Thank you, Mr. Chairman. It is my
pleasure to introduce today Randy Creamer of Columbia, South
Carolina. Randy is Vice Chairman of the South Carolina
Voluntary Organizations Active in Disaster, known as VOAD. He
is also the Director of Disaster Relief for the South Carolina
Baptist Convention and member of the VOAD in the Palmetto
State. For over three decades, Randy has served on the front
lines to help respond to disasters in South Carolina and around
the country.
Randy serves with the South Carolina VOAD Executive
Committee to enhance coordination among dozens of voluntary
organizations including Habitat for Humanity, the Salvation
Army, and the American Red Cross. South Carolina VOAD is an
affiliate of the national VOAD, which is an association of
nonprofit and voluntary organizations striving to mitigate and
alleviate the impact of disasters. Many American companies and
corporations are partners and supporters of this network. South
Carolina VOAD member organizations cover a broad range of
missions and technical expertise. Volunteers lead in many
aspects of disaster response and recovery, from preparing meals
and starting amateur radio operations to removing debris and
building new homes.
Randy's testimony today will discuss the role of voluntary
organizations in disaster relief and lessons learned from his
decades of experience.
Randy, we appreciate your leadership and hard work to help
improve disaster relief for South Carolinians and your
neighbors. Thank you for being with us here today. We look
forward to your testimony.
The Chairman. Thank you, Ranking Member Scott. Our final
witness is Ms. Danielle Koerner from Rutledge, Pennsylvania.
Ms. Koerner has experience with disaster management in many
different ways. She is, first of all, the mother of Joseph, a
9-year-old who lives with a disability, and previously she
cared for her mother with early onset Alzheimer's. Ms. Koerner
is also the Volunteer Management Coordinator for the Delaware
County Department of Emergency Services in Pennsylvania, in
southeastern Pennsylvania.
I want to thank Ms. Koerner for being with us today and for
sharing her expertise with the Committee.
Now we will proceed to our witness statements. We will
begin with Dr. Sue Anne Bell.
Dr. Bell, you may begin.
STATEMENT OF SUE ANNE BELL, Ph.D., ASSISTANT
PROFESSOR, SCHOOL OF NURSING, UNIVERSITY
OF MICHIGAN, ANN ARBOR, MICHIGAN
Dr. Bell. Chairman Casey, Ranking Member Scott, and
distinguished members of the Committee, it is an honor to
testify before you today regarding inclusive disaster
management. I am grateful for the opportunity to address this
Committee and appreciate your continued support of this
critical issue that affects older adults and people with
disabilities.
Let me state at the outset that the way we currently
mitigate, prepare for, respond to, and recover from disasters
is not inclusive or equitable. In this testimony, I will
describe that older adults and people with disabilities remain
disproportionately affected by disasters, that disruptions in
access to health care and necessary supports are a critical
need to be addressed in inclusive disaster management, that
strategies to promote aging in place throughout the phases of a
disaster can better support older adults, and that a whole
community approach to disasters is essential.
I am a researcher who studies disasters and health,
focusing on how to promote healthy aging in the face of an
increasing number of disasters. I am also a nurse practitioner
by training, and I regularly deploy to disasters across the
U.S. I witness firsthand the effects of the disasters I study,
the challenges of healthy aging during and after a disaster,
and the consequences of these events on individuals and
communities. Much of my work is focused on supporting
individuals with health care needs throughout a disaster.
In my experience providing health care in Puerto Rico after
Hurricane Maria, you might think that I treated injuries or
provided some kind of emergency care. In actuality, though, the
majority of the patients I treated were there for basic primary
care and management of chronic health conditions--diabetes,
high blood pressure, and kidney disease, for example,
conditions that require and benefit from regular and sustained
access to health care.
When communities are disrupted by a disaster, so are the
supports for those that live there and the normal patterns of
functioning in those communities. The loss of basic
infrastructure such as electricity or transportation can cause
serious care interruptions, especially access to health care,
which can have long-lasting health effects, especially for
those with chronic conditions.
Our team published a study that looked at how this
disruption affects long-term health through the lens of cancer
care, and we found that people with a cancer diagnosis who
lived through Hurricane Katrina died at a significantly higher
rate than people with the same characteristics and types of
cancer who did not live through a hurricane. Our takeaway was
that it was not the hurricane itself but, rather, the lack of
access to health care and normal patterns of healthy living
after the disaster that contributed to the greater rate of
deaths.
Inclusive disaster management should include promoting
aging in place throughout the phases of a disaster, with the
goal of supporting older adults to stay in their preferred
living environment. In our study of home health agencies
affected by Hurricane Harvey in Texas, 76 percent reported a
disruption in services despite that 99 percent of agencies
reported having the required emergency preparedness plans in
place. Nearly half of the disruptions of care services lasted 1
week or longer.
We have also studied older adults' preparedness through a
large national poll. Participants reported feeling confident
that they were ready to address a disaster but also reported
low levels of preparedness actions, the actual steps to be
ready for a disaster, like having an evacuation plan or putting
together a disaster preparedness kit. Critically, among older
adults who rely on electrical medical devices, that is,
nonbattery-operated medical devices such as an oxygen
concentrator, only one in four had an alternative power source
such as a generator.
I and my colleagues have also learned from home-based care
providers who have worked through recent disasters, including
Hurricanes Harvey and Irma and now the COVID-19 pandemic. Some
of our findings are that home-based care represents an
excellent insertion point to support readiness and to provide
older adults with the tools they need to protect their health
during an emergency.
We also found that home-based care is frequently not
included as part of the health care response to disasters,
where the focus is on hospitals and nursing homes. Home-based
care organizations reported feeling left on their own to care
for patients after disasters, where patients would be left on
their own if home-based care was not available. Including home-
based care organizations as a partner in emergency preparedness
planning is essential.
Inclusive disaster management must include systems for
continuity of care throughout all phases of a disaster, and
that starts with strengthening relationships in the whole
community among emergency managers, health care coalitions,
aging organizations, home-based care providers, to name a few,
and most importantly, including the voices of older adults and
people with disabilities centered as the key stakeholders.
Thank you again for the opportunity to participate in
today's hearing.
The Chairman. Dr. Bell, thank you for your statement.
Before we introduce our next witness, I also want to
acknowledge we have been joined by Senator Warnock of the State
of Georgia.
Next we will turn to Dr. Spurlock.
Dr. Spurlock, you may begin.
STATEMENT OF WANDA SPURLOCK, Ph.D., PROFESSOR,
COLLEGE OF NURSING AND ALLIED HEALTH, SOUTHERN
UNIVERSITY AND A&M COLLEGE, BATON ROUGE, LOUISIANA
Dr. Spurlock. Thank you, Chairman Casey, Ranking Member
Scott, and distinguished members of the Senate Special
Committee on Aging for affording me the opportunity to speak
with you today. My name is Dr. Wanda Raby Spurlock, and I am a
professor of nursing at Southern University and A&M College
located in Baton Rouge, Louisiana.
For over 2 years following Hurricane Katrina, my School of
Nursing delivered primary health care services at one of the
largest FEMA transitional trailer sites in the State. Based on
our unique experiences, I will highlight a few of the important
issues that were evident and that impact the well-being of
older adults and persons of disabilities when confronted with
major disasters.
Timely access to medical and support services following a
disaster is critical. However, treatment for chronic
conditions, such as hypertension and diabetes, can often be
delayed for period of time, leading unfortunately to poor
health outcomes. Many older adults had lost their assistive
devices and home equipment needed to monitor and treat various
medical conditions. In addition to being separated from prior
systems of health care, these evacuees were also separated from
their social support networks, including family and friends,
some of whom had been evacuated to other states. Our work has
revealed that most evacuees did not have an emergency plan in
place in the event of a disaster, highlighting the need for
more targeted work in this area.
Detailed information about the School of Nursing's role in
delivering health care following Katrina can be found in the
publication by Spurlock, Brown and Rami, ``Delivering Primary
Health Care to Hurricane Evacuees: The Role Schools of Nursing
Can Play,'' published in the American Journal of Nursing.
Based on my experiences in the disaster arena, the
following key issues are paramount regarding older adults and
persons with disabilities and should be addressed in disaster
planning, funding, and policy decisions:
1. Effective and holistic planning is critical to the
success of disaster response and recovery, the full inclusion
of older adults, disabled persons, and others with access and
functional needs is necessary to mitigate the impact of
disasters on these vulnerable populations.
2. Access to health care and other supportive services is
critical following a major disaster, especially when evacuees
are forced to relocate to other states, thereby risking the
loss of desperately needed long-term care services and
supports.
3. Training and resources must be made available to support
community-based organizations to ensure equitable access to
services and programs, to prepare and support vulnerable
populations during and after disasters, including integration
back into the community.
4. Prioritization in disaster research funding to inform
evidence-based action and policy decisions that support the
needs of older adults and persons with disabilities across
diverse ethnic and minority groups is warranted.
As a Nation, we must continue to seek solutions to overcome
the unique challenges that older adults and persons with
disabilities face when preparing for, responding to, and
recovering from disasters. I was pleased to read about several
recently introduced legislation that addresses many of the
issues that I have presented.
The passage of the Real Emergency Access for Aging and
Disability Inclusion, REAADI Act, will ensure that the life
experiences and voices of persons with disabilities, older
adults, and others with access and functional needs are
included in the preparation, response, recovery, and mitigation
of disasters. This inclusion is paramount to ensuring the best
possible outcomes for these vulnerable populations.
The Disaster Relief Medicaid Act, DRMA, ensures that
Medicaid-eligible persons forced to relocate from an area under
a Presidential disaster declaration to another State will be
able to maintain their Medicaid-supported services, including
home-and community-based services. Passage of DRMA will address
many of the issues that impacted the health and wellbeing of
evacuees following Hurricane Katrina and also will impact their
health in future disasters.
As the Nation continues to recover from the COVID-19
pandemic and in preparation for future disasters, the FEMA
Empowering Essential Deliveries, FEED, Act allows the
government to pay 100 percent of the cost to states and
localities so that they can partner with restaurants and
nonprofits to prepare nutritious meals for vulnerable
populations desperately in need.
In closing, I would like to thank you again for this
opportunity to share my thoughts and experiences as a nurse
clinician, educator, and researcher.
I once read a quote by Mahatma Gandhi, ``The true measure
of any society can be found in how it treats its most
vulnerable members.'' Progress has been made in disaster
planning, response, and recovery although there remains work to
be done to ensure the best possible outcomes for older adults.
Passage of these legislations will present a significant step
in solving many of the issues that I have presented, and I
commend the Senate Special
Committee on Aging for shining a national spotlight on this
important issue.
Thank you.
The Chairman. Dr. Spurlock, thank you for your testimony.
We will turn next to Mr. Creamer.
STATEMENT OF RANDY CREAMER, VICE CHAIRMAN, SOUTH
CAROLINA VOLUNTARY ORGANIZATIONS ACTIVE IN
DISASTER (VOAD), COLUMBIA, SOUTH CAROLINA
Mr. Creamer. Good morning, Chairman Casey and Ranking
Member Scott and members of the Committee. My name is Randy
Creamer. I am a native and resident of South Carolina. Over the
past 35 years, I have served as a volunteer and a professional
assisting those affected by natural and manmade disasters.
Bringing health and healing and hope to individuals and
families and communities has been the most rewarding work of my
life. Thank you for the opportunity to share a brief testimony.
National VOAD, as already mentioned, is an organization
that provides cooperation, communication, coordination, and
collaboration, and fosters more effective delivery of services
to communities affected by disasters. Founded over 50 years
ago, National VOAD is a coalition of 70 of the Nation's most
reputable national organizations. They are faith-based,
community-based, and other nonprofit organizations as members.
Our South Carolina VOAD is committed to the ``4 C's,'' with
a strong focus on communication amongst members engaged in a
specific response. Our VOAD in South Carolina is not
operational in the sense of telling any organization what they
can or cannot do, or where they can or cannot serve. We strive
to enhance effectiveness in assisting those who are hurting.
Many volunteer organizations are involved in the initial
response only. Others may not be involved for weeks or even
months, but each organization brings its strengths to the
table. Few, if any, of those organizations are engaged from the
first hours of an event to the complete recovery, which can
take several years.
The South Carolina Baptist Convention became involved in
disaster relief in 1990 following Hurricane Hugo. Today we have
2,500 volunteers who have attended our training, completed
background checks as part of our credentialing process, and
prepared to assist others affected by disasters in South
Carolina, across the U.S., and occasionally even
internationally. We are part of the larger Southern Baptist
Disaster Relief Network that encompasses all 50 states. This
year we sent 19 teams to the Hurricane Ida event. Those teams
went to both Louisiana and Pennsylvania, serving.
Our primary task is to provide immediate assistance after
various wind events like tornadoes or hurricanes or
thunderstorms or flood events that can occur after a tropical
system or some heavy rain event. Our volunteers typically sleep
in church buildings on cots or blowup mattresses, and they
bring along mobile showers and laundry trailers and volunteer
cook teams and all the logistical support that they need.
Another major task is to partner with the Salvation Army
and the American Red Cross when mass feeding is required to
support those who have been evacuated and support those who are
unable to prepare meals for themselves.
Aside from myself and two coworkers, all South Carolina
Baptist disaster relief is provided by volunteers, most of whom
are retired. Our volunteers are motivated by their personal
faith in Jesus Christ and the desire just to love God and love
others. They are our most valuable resource.
The American Red Cross and the Salvation Army lead the way
in providing mass care. United Methodist congregations provide
much of the same kind of service as Baptist. The Presbyterian
Disaster Relief and Adventist Community Services Disaster
Response are other major partners that lead the way in the
long-term recovery. We are blessed with numerous partners.
Over the years, we have learned a number of critical
lessons. We have learned the disaster impacts increase
substantially on structures and houses that have preexisting
deferred maintenance issues.
We have also learned that we cannot do everything. You have
to find your niche and really do it well.
We have learned that we cannot help everyone. We have to
prioritize and identify the most vulnerable. Our priority is on
those who are unable to help themselves. They lack financial
resources, have no one else to help them, for example, widows,
single adults, certainly retired folks or grandparents raising
grandchildren, single parents.
We also strive to help our body of first responders that
are often neglecting their own personal needs and family needs
because they are serving the community.
Finally, we have learned that we have to allow our
volunteers a great deal of leeway in the ways that they
respond, like if they discover a lady lost her refrigerator and
all of her food and we are just there to take trees off the
roof, but in turn they buy her a refrigerator and restock her
pantry.
In closing, I am pleased to say that for 54 years we have
been involved in and depended on retirees for most of our
volunteers within the Southern Baptist Network. As one
generation ages out, the next one steps up. Today we are
excited with the number of college students that join us. We
look forward to serving our neighbors in disaster relief for
years to come, and we do appreciate the opportunity to share a
little bit about our story.
The Chairman. Mr. Creamer, thank you for your statement. We
appreciate you being here.
We will next turn to our fourth and final witness, Ms.
Koerner.
STATEMENT OF DANIELLE KOERNER, VOLUNTEER
MANAGEMENT COORDINATOR, DELAWARE COUNTY
DEPARTMENT OF EMERGENCY SERVICES,
RUTLEDGE, PENNSYLVANIA
Ms. Koerner. Chairman Casey, Ranking Member Scott, and
members of the Committee, my name is Danielle Koerner, and I
will be speaking today as an advocate, former unpaid caregiver,
and as a first responder and emergency planner. Thank you for
this invitation to share my professional and lived perspectives
on this topic.
I sit before you a circumstantial expert. For the past 20
years, I have volunteered and worked in the field of emergency
services in Pennsylvania, first as an EMT and paramedic
providing direct patient care and advocacy, then in education
regulatory compliance.
In 2012, my husband and I were blessed with the arrival of
our first son, Joseph. He was born healthy but with multiple
deformities and congenital amputations in his extremities,
requiring surgical intervention, ongoing therapy, and adaptive
equipment. In 2015, my 54-year-old mother was diagnosed with
early onset Alzheimer's and dementia, and my husband and I
became her primary live-in caregivers while my father continued
to travel for work. I became an expert at anticipating needs,
adapting everyday situations and tasks to the physical needs of
my son and cognitive and behavioral needs of my mother.
I had binders of bills tabulated with notes about insurance
coverage and payment plans, calendars full of appointments. I
gained a new vocabulary and set of skills specific to advocacy
for my child and mother, and began to think 10 steps ahead for
every task to assure that the needs of my loved ones would be
met in everything that we did, both in non-emergency ``blue
sky'' situations and ``dark sky'' emergencies. I built
contingency plans for care, kept outgrown medical equipment in
case something broke, and kept extra comfort items in strategic
areas to soothe fears and calm erratic behaviors.
To say that I received a crash course in accessibility and
advocacy would be an understatement. I became a survivor before
an emergency had occurred.
In 2018, my mother lost her fight. I was both devastated
and grateful that she had found peace. It was that same year
that I was offered the job of Outreach and AFN, or Access and
Functional Needs, Coordinator for the Delaware County
Department of Emergency Services. I leapt at the opportunity,
hoping to integrate my lived experience with professional
knowledge of emergency services, both to honor my mother and
assure that people like my son were considered before, during,
and after disasters and emergencies happened.
Very quickly I learned that my primary function in this new
professional role was to be the voice in the room reminding
planners and responders that one size never fits all, that
accessibility means more than wheelchair ramps, that not all
disabilities are physical, and that all of us will likely have
an access need at some point in our lives.
I also found myself regularly educating planners and
responders that individuals who live every day with
disabilities, seniors who have access needs, and individuals
who are unpaid caregivers or survivors, a good way to describe
them is ``pre-survivors'' even before the emergency has
happened. Often, they are surviving against the odds, outliving
expectations and resources, making due with inadequate
services, living situations or equipment, and recovering from
medical, financial or emotional setbacks because of their
personal normal. We, as responders, planners, emergency
managers and as policymakers, cannot begin to plan for the
whole community without first embracing this knowledge.
The reality is that if we want to be successful in disaster
mitigation the work must also be done in the fields that
operate independent of emergency management, the everyday
``blue sky'' supports. We must focus on assuring that
circumstances that make individuals pre-survivors are addressed
well before the disaster occurs and stop limiting our
conversations on inclusive disaster practices to the disaster
itself.
Working to enhance accessibility to government services by
streamlining technologic and paper platforms, useful resources
and applications, simplifying processes and terminology,
expanding regular operation hours for services, and assuring
that resources are known to those who most need it through
multi-outlet and media messaging are all just as important as
ensuring physical accessibility to buildings.
Investing in workforce development and support for direct
care and medical professionals, as well as case managers and
social workers, is another critical piece of the puzzle.
Addressing our Nation's housing crisis through the lens of
accessibility and bolstering programs designed to increase
independent and supportive living for individuals who need it
most, expanding the criteria for Medicaid and Medicare
reimbursement and coverage, assuring financial support to
unpaid caregivers, and increasing programs that offer respite
services will help.
These examples only begin to scratch the surface of this
topic. The best way to ensure optimal outcomes for pre-
emergency survivors is to ensure that they have unobstructed
access to the supports that they require daily and to include
individuals with personal knowledge of these requirements to
guide the process.
The frequency and intensity of natural disasters are
increasing, and the emergency response workforce is decreasing.
Paid and volunteer workers are harder than ever to find in my
field of work. If we can improve the lives of individuals with
disabilities, seniors with access needs, and unpaid caregivers
before the emergency happens, we will exponentially increase
the resiliency when it does.
Thank you for your time today.
The Chairman. Ms. Koerner, thank you for your testimony. I
will start a round of questions with you. I want to say with
regard to your testimony, as well as our other witnesses, all
four witnesses, it is especially heartening when witnesses can
bring to a hearing not just professional lived experience but
also personal experience, and that is true of all of our
witnesses today, and that is certainly true of you, Ms.
Koerner.
In your testimony, you said you leaped at the opportunity
to work in disaster management to, quote, integrate your lived
experience with professional knowledge of emergency services,
both to honor your mother and assure that people like your son
were considered before, during, and after disasters happen.
Unfortunately, not every community is as fortunate as your
community to have an expert with lived experience to serve that
community, in your case, to serve in Delaware County in the
emergency services department. For those communities without a
person with lived experience at the planning table, national
services like technical assistance, like a technical assistance
center, can help State and local governments with inclusion, in
other words, to do the work that you and others have done
locally.
The question I have for you is: How would enhanced
representation and technical assistance programs like those
included in my legislation, the REAADI Act--how would that help
to save lives during disasters?
Ms. Koerner. Thank you for that question. First, I have to
advocate that every community strive to include local
stakeholders who have disabilities, caregivers, advocates, and
seniors who have access need at their local process wherever
possible, understanding that these individuals may not have a
background in emergency management.
That being said, having access to individuals who have both
personal, lived, and professional experiences through national
technical assistance programs will connect these communities
with critical information during planning, expert guidance
during the response and then later during the recovery process.
While knowing that needs truly are in the community and knowing
what those needs are in the community is the first step, having
the access and expertise to address them strategically is what
will ultimately increase life-saving communications and
operations.
The Chairman. I was noting on the second page of your
testimony one paragraph that, at least for me, summarized a lot
of your testimony and what we have got to focus on in terms of
a list of priority areas for our work. You indicated in the
middle of the page, quote, working to enhance accessibility to
government services by streamlining technologic and paper
platforms; second, simplifying processes and terminology;
third, expanding regular hours of operation for services; and
fourth, assuring that resources are known to those who most
need them through multi-outlet and media messaging that are
just as important as assuring physical access to buildings.
That is a good summary of what we would hope every community
would be able to avail itself of.
Ms. Koerner, thank you for your testimony.
I will move my second question to Dr. Bell. In your
testimony, you talked about the research you had done on the
health effects of disasters on people with chronic conditions,
which is more than 80 percent of seniors. You found that
survival rates were lower for people exposed to Hurricane
Katrina than for those that did not experience a storm likely
due to a disruption in access to health care.
You noted, quote, the loss of basic infrastructure can
cause serious care interruptions, especially access to health
care, which has long-lasting effects for those with chronic
conditions, unquote, quoting again from your testimony. Going
without health care is, of course, for all of us unacceptable.
I introduced a particular piece of legislation called the
Disaster Relief Medicaid Act to ensure that people affected by
disasters can keep their Medicaid coverage. People are
uprooted, and they move, and we want to make sure they can
still access Medicaid if they have had to move.
Can you discuss how policy solutions like this act would
help people access their medical care and, indeed, even save
lives following a disaster?
Dr. Bell. Thank you for that question, Chairman Casey. I
think one important thing to consider is that disasters do not
respect State lines and neither do health care needs. Thinking
about how to access for people--thinking about how people can
access health care needs who have Medicaid, the ability to
access their health care needs in a different State where they
may have evacuated to is crucial. We have to think about ways
to meet health care needs, and this is a solution that feels or
seems fairly straightforward if we can eliminate unnecessary
delays and red tape that have characterized past disasters.
The Chairman. Well, Dr. Bell, thanks very much for that
answer and also for your testimony. I was noting in your
testimony at one point something that--and I hope I can get
back to this later, but it really kind of jumped off the page.
This is on page three. You start the paragraph by talking about
older adults and people with disabilities are
disproportionately affected by disasters. The next sentence is
``Disasters are not natural.'' That is, for a lot of people,
counterintuitive.
You explain by talking about hazards such as hurricanes,
wildfires, and tornadoes are weather events that occur as
natural processes but that we know that the impacts of climate
change advance is driving this, and then you say, and I am
quoting, ``The impact these events have on communities is
largely human-made and influenced by social, economic,
geographic, and political processes.'' I will get back to you,
I hope, a little later about that, to have you walk through
that, but that was an interesting formulation for me to read
and to give me a better perspective on what we are up against.
I will turn next to Dr. Spurlock. You have a unique
perspective in that you research disaster management and you
live in southeastern Louisiana, which has seen--to say that you
have experienced severe weather events, extreme hurricanes over
the past two decades, of course, is an understatement. Not many
regions of the country have had as much in the way of disasters
and challenges as the State of Louisiana and that section of
the State.
In your written testimony, you noted that ``populations are
not equally impacted by a disaster.'' How would equitable
representation through the programs that we outline in the
REAADI for Disasters Act--how would that equitable
representation create life-saving approaches during disasters?
Dr. Spurlock. Yes. Thank you, Chairman Casey. We know from
our research, and it is widely accepted, that certain
populations will experience a disproportionate burden when
confronted with disasters and those populations mainly include
older adults and persons with disabilities of all ages. We know
in terms of some of the changes that occur with aging,
including impaired sensory functioning, impaired vision,
hearing, especially impaired mobility and changes in cognition
and chronic medical problems that necessitate ongoing treatment
with medications and sometimes lifesaving equipment, can put
those populations at a greater risk when it comes to response
to hurricanes or any type of disaster, including recovery
phase.
I was pleased to learn about legislation that has been
introduced that will bring representatives from vulnerable
populations to the table to actively participate in disaster
planning because we know that the success of the recovery and
the response phases will largely depend on the efficacy of
plans that have been put in place to mitigate some of the
negative disaster outcomes that can occur. Not only bringing
them to the table is important, but also including a diverse
representation of older adults and persons with disabilities in
recognition that their life experiences and needs can widely
vary. These represent significant steps toward solutions to
improve our disaster response.
The Chairman. Well, thanks for making the point about not
only representation but equitable representation and
highlighting some of the legislative approaches and even
solutions we can bring to bear.
I am going to jump back Dr. Bell to highlight another
segment of your testimony. In your testimony, you indicated
that, quote, inclusive disaster management should include
promoting aging in place throughout the phases of a disaster,
with the goal of supporting older adults to stay in their
preferred living environment, unquote.
You also noted that in your study of over 2,000 older adult
respondents that although the majority felt confident in their
ability to address a disaster they actually have taken low
levels of preparedness actions, like having a disaster plan and
kit. This highlights, of course, the need for support in
turning intention into action.
Your research has also shown that home-based care providers
are an excellent starting point for disaster management.
Can you discuss how investing in home-and community-based
service will improve the ability of older adults and people
living with disabilities to remain healthy and safe leading up
to, during, and after disasters?
Dr. Bell. Thank you for that question. We know already that
people want to stay in their preferred living environment and
having home-and community-based services are the kind of
supports that can help them stay in these settings. Home-based
and community support services, investing in these is a good
idea in general. We already know that the population of older
adults is increasing, and home-based care needs and the home-
based care industry will have to increase as well to be able to
meet these needs, so investments in this area in general are an
important need.
During a disaster, if staying at home is the safest option,
then let us give providers and older adults and people with
disabilities the tools to be able to stay at home and live
through a disaster safely in their preferred living
environment. We can start by investing in home-based care and
community supports, disaster preparedness, and response
capabilities.
Another thing that we can do is to encourage that whole
community approach that we have already talked about, where
home-based care organizations, community supports, emergency
managers, and the stakeholders themselves, older adults and
people with disabilities, can better interact together around
inclusive disaster management.
The Chairman. Well, thanks very much for that and
highlighting the kind of setting we are talking about, that if
you are in a home-based setting that allows for the caregiver
to be obviously more present and potentially more able to do
the kind of planning with that older adult or that person with
a disability.
Just a brief follow-up, Dr. Bell. One thing we are trying
to do now is to allocate time for Senators as they come back
from other hearings in the next 10 minutes or so. I will be
asking a few additional questions, but as a follow-up, one of
the central elements of the Build Back Better legislation will
be an investment in home-and community-based services. It is
predicated on a piece of legislation I introduced, the Better
Care Better Jobs Act, with which I know you are familiar.
Doctor, in regard to that legislation, I wanted to ask, how
much would the policy that is embedded in the Better Care
Better Jobs Act--how would that support both homecare workers
and family caregivers to improve the prospects for dealing with
disaster management for those that the individual worker is
serving, in this case, a person with a disability or an older
adult?
Dr. Bell. Well, I think what it comes down to is we need
the kind of investments that can better support this industry,
the home-based care industry. By home-based care, I think it is
important to define that this is not--this includes an array of
health care that is provided in the home. That could be skilled
nursing services, physical therapy, other types of
rehabilitation therapy, and also homecare, which is support and
assistance with activities of daily living that are necessary
to allow for individuals to come--to continue living in their
home.
Advancing policy that can better support these industries
and these providers themselves to provide the kind of care that
can support individuals and communities is really critical. I
think it is very important that we start thinking of this as
mitigation measure, if we are thinking about inclusive disaster
management, that health care occurring at the home is a new
normal going forward, and we need to make investments that
support that.
The Chairman. Well, Doctor, thanks very much.
I want to turn next to Mr. Creamer. I was particularly
impressed by the scale of the volunteer efforts that you made
reference to in your testimony and the number of communities
you and so many others have served. It is remarkable.
I noted as well that you made reference to one of a number
of your teams going throughout the country, including to
Pennsylvania. As a Senator from Pennsylvania, as a citizen, I
appreciate the help that was provided in those terrible
circumstances in communities that we faced. A lot of the
communities this summer and fall were communities in the
southeastern part of the State, where Ms. Koerner is doing her
work, so it is entirely possible that they were crossing paths
with folks that she was working with.
My question for you, Mr. Creamer, is you provided a fulsome
description of how the volunteer workforce can address many of
the immediate needs that people experience in a disaster. The
work that the South Carolina VOAD does is critically important.
Can you tell us how the volunteer workforce coordinates with
community needs in more formal supports such as Ms. Koerner's
emergency management program?
Mr. Creamer. Yes, sir. Thank you for the question. When we
go into communities like Horsham, Pennsylvania, where we were
north of Philadelphia just a few weeks ago----
The Chairman. Right.
Mr. Creamer. We seek to connect with officials in those
counties and those communities immediately. We will go to a
fire chief, police chief, emergency manager for a county or
parish. Sometimes it is pastors in local communities. They can
steer us in the right direction, where the most vulnerable
populations are concentrated, that need the most help. Here are
the things that we can offer, and then you direct us to where
we can be most effective to help and assist you in your time of
need. We are looking very much at the local officials there to
give us that guidance and direction. That is our point of
connection.
The Chairman. Well, it is noteworthy in your testimony
about the challenges that volunteers face. Sleeping in church
buildings on cots and blowup mattresses, that could be
challenging for someone at any age, and we are grateful for the
work that they do and that you and others have made apparent
today in your testimony.
I will now turn again to an additional question as we wait
for one or two Senators who are on their way.
Ms. Koerner, I will turn back to you now that we have made
reference to, as Mr. Creamer did, southeastern Pennsylvania.
Appreciate the work that you have done in our State and in a
big county like Delaware County. For those of you who do not
know, it is a suburban Philadelphia county. It is, gosh, I
think about our fourth or fifth largest county in the State
after Philadelphia, Allegheny, Montgomery, and Bucks. Delaware
County I know is well more than half a million people, so there
is a lot of challenges when a disaster hits in a high
population, suburban community.
Ms. Koerner, you talked in particular about your personal
circumstances being a ``crash course in accessibility and
advocacy'' and preparing to be ``a survivor before an
emergency.'' So that kind of crash course is not only a good
preparation for you and your family. It is, of course, of great
value to the people of Delaware County and our State generally.
The REAADI for Disasters Act and the recently implemented
Pandemic and All Hazards Preparedness and Advancing Innovation
Act, another long name which we use the acronym PAHPA. Then
that word ``innovation'' was added when we reauthorized the
legislation, the preparedness legislation which has been--was
first acted on way back in 2006 and has been reauthorized
several times since then.
In both of those bills, part of the focus of both of those
bills is the creation of advocacy, I'm sorry, the creation of
advisory councils with a high level of aging and disability
representation to inform disaster management planning. If you
are going to have a strategy in place at a national or State or
regional level, and you make it a priority to address the
impact of a disaster on an older American or a person with a
disability, you have got to have representation, as Dr.
Spurlock made reference to earlier, representation on those
advisory councils.
The good news is we have advisory councils. The bad news is
they need to be put into action. It has been far too slow. We
will get to that later.
The question I have for you, Ms. Koerner, is: How have your
experiences as a family caregiver shaped your approach to
disaster management at a very local level?
Ms. Koerner. Thank you for the question. I learned very
quickly from my mother and from my son that needs should never
be assumed but always anticipated. Assuming needs was a really
good way to offend my mother, who was, prior to her diagnosis,
probably the most capable woman I have ever known, so instead,
anticipating her needs and taking her lead was a much better
approach.
Now as the mother of a budding preteen who happens to have
physical differences, the same applies. He has far more to
teach me when it comes to what he needs than I have to teach
him.
Working with, and seeking out, input from individuals who
have access and function needs is the only way to learn what
the needs of our community really are and how best to
anticipate areas where assistance may be needed during and
after the disaster emergency has occurred, as well as gain
invaluable insight as to how we can work to overcome challenges
by taking their lead. Really striving to make sure that we are
coming into the situation knowing that we are there to take
their lead and we are there to serve them I think is the best
way to approach the situation, and that is what I have tried to
bring into my work.
The Chairman. Well, it has to help enormously to have
personal experience in addition to professional lived
experience. That combination I can only imagine. I have never
done this kind of work myself, but I can only imagine the
positive impact it must have on someone who is challenged by,
or even overwhelmed by, a disaster, to be able to talk to
someone who can relate to them on a very personal level, being
able to say I have some experience with this kind of
circumstance or my in your case, your mom and your son and
other family experiences that you can relate to them as opposed
to someone without that experience who might have the expertise
but may not have the personal experience and the understanding
that you can bring to bear when you encounter someone who is
really in jeopardy and not knowing what the next hour or the
next day will bring, when they are overwhelmed by a disaster.
I have often told the story about my own experience as a
legislator, having some sense of what people undergo when they
experience a natural disaster, but not really fully
understanding it at least in my own case until 2011. We had
terrible, devastating flooding in several parts of our State. I
live in northeastern Pennsylvania, and I remember visiting
rural communities in northeastern Pennsylvania and seeing the
devastation but also just seeing how violated individuals felt,
in a very deeply personal way.
I tell the story often about a friend of mine who is a
lawyer in a neighboring county, and he was the most confident,
upbeat, even cocky person you would ever want to meet. Never
down. Always upbeat. Always ready to tackle any problem. Full
of self-confidence.
When I said hello to him at a stop at a disaster site,
where there was terrible flooding and a lot of families had
their homes either flooded out completely or badly damaged, his
was one of the homes. I remember walking up to him, you know,
putting my hand out to shake his hand, thinking that he would
say, you know, I had some flooding, but I am good. As soon as I
shook his hand and looked in his eyes, he started to cry. I
never thought I would ever see this very strong, confident
person be so devastated, so it gave me an insight I did not
have before. I can only imagine, Ms. Koerner, the number of
times you have been able to draw upon your own experience.
Dr. Bell, I will jump back to you for an additional
question. We know that this kind of preparedness, emergency
preparedness, is a top concern of several government agencies.
In the Federal Government, the Department of Health and Human
Services Inspector General just released an annual report. I
will not make detailed reference to it but just holding it up.
This is a Health and Human Services Inspector General report
which is a report of management challenges for the Department.
This was just released earlier this week.
It comes after our Nation has spent 2 years living with a
pandemic, that as I made reference to earlier, that terrible
number that keeps going up of 760,000 lives lost in the grip of
the pandemic. COVID-19 has been a lesson in preparedness
shortfalls, reinforcing why the Department's independent
watchdog says that HHS must do much more to prepare for these
emergencies.
Dr. Bell, the Obama Administration updated emergency
preparedness rules for both Medicare and Medicaid providers for
the first time in a quarter century. These were implemented in
2017. In light of the pandemic and the Inspector General's
concerns as expressed very recently, are Medicare's emergency
preparedness rules sufficient--sufficient--to address the needs
of people with disabilities and older adults in nursing homes
and other congregant settings during disasters?
Dr. Bell. Thank you for that question. You mentioned the
COVID-19 pandemic, and over the course of the past 18 months of
the pandemic I have had the opportunity to visit a number of
nursing homes where I provided training in personal protective
equipment use and conducted voluntary infection control
assessments in order to support staff, their own safety and the
safety of the residents of those homes, so definitely an area
that is near and dear to me.
You mentioned the CMS emergency preparedness rule, which I
believe was introduced in 2016 and put into effect in 2017. The
goal of the emergency preparedness rule was to implement
national standards for healthcare organizations that are
receiving Medicare and Medicaid funding. This was introduced, I
believe, largely to avoid the kind of tragedies that have been
seen in nursing homes and other health care settings prior to
2017, but unfortunately, we are still seeing many of those
challenges and lack of preparedness even after the
implementation of the rule.
I think a couple things about the Inspector General's
report and the emergency preparedness rule itself. One is that
the rule was implemented now between four and 5 years ago, and
we do not have a substantial amount of evidence to understand
if the rule is working in the way that it should be working.
I think it is important to note that the intention of the
rule is an important and a good one. Facilities should be--
should have emergency preparedness plans, and they should be
preparing their employees using a set of standards, so that is
an important one.
The rule was implemented with a fair bit of leeway,
allowing healthcare organizations to determine the type of
training and drilling and plans that they wanted to do. I think
that there is a balance between allowing this leeway and being
overly prescriptive. That really matters for low performing
settings that do not have good training, drilling, and plans in
place. It may unnecessarily penalize, or not--maybe penalize is
not the right word. It may be unnecessarily prescriptive for
organizations that do put a fair bit of emphasis on being
prepared.
I think what my recommendation or solution is, is to
provide better opportunities for tailoring of emergency
preparedness planning for organizations for thinking about
older adults and people with disabilities. How can we better
tailor emergency preparedness plans to the organizations that
are providing care for those individuals? How can we do a
better job of supporting organizations in their emergency
preparedness planning without providing new--or without taking
away some of that leeway that has been successful.
The Chairman. Doctor, thanks very much.
I will turn next to Ranking Member Scott.
Senator Tim Scott. Thank you, Mr. Chairman.
Let me ask a question of Mr. Creamer as it relates to
heirs' property and the importance of the changes that have
been made based on the request that we submitted, Senator
Ossoff and I. When recovering from disasters, how big a problem
was the lack of a title to heirs' property for rural, majority
minority counties in South Carolina?
Mr. Creamer. Thank you. Thank you for the question, Senator
Scott. In our role going in, in the early hours, the first few
days of doing what we do in helping that initial recovery and
mitigating continued damage, that was not that big of an issue.
The issue really becomes huge when we start the rebuilding,
long-term recovery process, or if that resident is trying to
access different sources of financial assistance, be that
particularly the FEMA assistance for damage to a homeowner.
That proof of title is almost a deal-breaker in those
instances. It does not stop us from doing what we do, but when
it moves into long-term recovery it is a huge obstacle.
The work that the organization we have down in the
Charleston area, that is helping with that, has been huge to
help those families that have owned property for upward--well
over 100 years, but there is no proof of title, and they do not
have the resources to go do a title search many times.
Senator Tim Scott. I see. In other words, the work that you
do, which is excellent work by the way--thank you for doing it.
It is not impeded by the heirs' property challenges that we see
across the country and specifically throughout the South.
When it comes to receiving the resources from FEMA, the
heirs' property, the lack of a clear title--I should be clear.
I am so used to saying ``heirs' property'' as if everybody
listening to us knows what heirs' property really is. In fact,
they may not. As land is passed down within families, you have
so many heirs. Sometimes no individual person within that
family has clear title. Therefore, heirs' property is property
really held in common in many ways. That common property being
held in common does not give any specific person the right to
advocate on behalf of that property, so that also stops that
family of individuals from being able to receive assistance
from FEMA. Is that what I heard you say, sir?
Mr. Creamer. FEMA and other sources of assistance. It can
be from faith-based organizations. Everybody wants proof of
property ownership.
Senator Tim Scott. Yes, sir. Thank you very much.
Dr. Spurlock and Dr. Bell, do you agree that we need more
flexible funding to support local restaurants cooking fresh,
healthy meals during disasters? In other words, the FEED Act
that we have spent a lot of time working on, that both the
Chairman and I are now co-sponsors of. Would it not be helpful
to have more funding support for local folks who understand and
appreciate the severity of the challenges faced by those
communities where the disasters happen within?
Dr. Spurlock. Yes. Thank you for that question and
statement. As a resident of Louisiana, having experienced
numerous disasters, namely hurricanes and floods, I know
firsthand of the importance of having those types of resources
available. Recently following Hurricane Ida in my community, we
experienced power outages. I did personally for over five days
or so. Myself, and other individual households lost all of
their perishable goods from the refrigerator and freezer.
A larger percentage of persons with disabilities reside in
southern states. States that border the Gulf of Mexico are more
prone to these types of disasters.
Poor communities oftentimes where older adults live are
considered food deserts.
Senator Tim Scott. Yes, ma'am.
Dr. Spurlock. Yes. Just having the availability of
resources on the ground to be able to offer a warm, nutritious
meal, served with a smile, in a person's local community, so
they aren't faced with additional hardships such as having to
seek transportation to drive miles to perhaps locate a
restaurant that is open, only to find that the line is several
blocks long. Still having to leave hungry and not having access
to a nutritious meals, so that's a really win-win, I think for
all parties involved.
Senator Tim Scott. Thank you, ma'am. If you are waiting in
a line that long, Mr. Chairman, you are going to be hungry and
frustrated. Yes, so that is a fact. Thank you, ma'am.
The Chairman. Mr. Creamer, Mr. Scott, thank you very much.
We will turn next to Senator Braun.
Senator Braun. Thank you, Mr. Chairman. You know, when it
comes to something this important, to where it is random in its
occurrence and we know that it is inevitable over time, I think
we ought to do something that puts better processes into place.
It would mean that you have got to make sure that when you do
have to be quick and be responsive that you have got the
funding in place, number one, and then also guidelines where
you are not wasting any time before you can actually get to the
issue at hand because so often it seems like we are ill
prepared in terms of the immediacy of it, in terms of whatever
structure and processes that should be in place, where there is
fumbling around.
The bigger issue is probably how we pay for it in the long
run. For things of this significance, most places would have a
designated rainy-day fund, to where it would be funded
separately, where it would be ready to go. Ideally, it would be
in the context as we become more fiscally responsible over
time, borrowing money to pay for our operating budget currently
to the tune of about 25 percent and soon to go up even to a
higher percentage. I think there really needs to be some reform
on general fiscal issues here.
I would like to direct my question here to Mr. Creamer.
Tell me what you think the current status is on the guidelines,
the processes, the things that are needing to be in place, to
where you know what to do when the tragedy, the event, occurs?
Then what are your thoughts on establishing a rainy-day
fund? I have got legislation that would like to do that, to
where we are not then on an ad hoc basis having to put funds
into play, to where we have better, ready-to-go functions and
processes, number one, and then number two, a rainy-day fund
that will support it, where we are not scrambling around in
terms of how to fund something in the immediacy of the
incident. Mr. Creamer?
Mr. Creamer. Thank you sir. A great question. Yes, I agree
wholeheartedly the second question, the part dealing with
funding, to have a rainyday fund in your back pocket, so to
speak, that you can draw from would be a huge asset because
funding does become such an issue for everything that we are
doing. Even in our role of volunteers, we cannot do what we
cannot fund, so having that as a backup is certainly warranted
as such.
Looking at the ways that we can be prepared and how we do
it is just positioning both the professional, if you will,
response as well as utilizing some of the volunteer respond
groups across the country as a huge asset and just both working
together, having those communicate closely. Our VOADs enable us
to do that through our states as well as the national level.
That is the best way we have is to have those relationships, to
know each other, and to work and be ready prior to any kind of
event, any kind of challenge that we experience.
Senator Braun. Well, thank you. As a closing comment in
general, for anyone watching out there, we currently have a
Federal budget that runs around $4.5 trillion, and we currently
raise revenues to the tune of $3.5 trillion. That is a
structural trillion-dollar deficit that we have come to accept
and kind of shrug off as not being important. That does not
work in any other place. All State governments live within a
framework, to where they generally have cash reserves and
rainy-day funds set up.
It also brings to light that in the amount of money that we
are currently wanting to spend, and that remains to be seen how
much of that will be borrowed versus paid for, I think
certainly it is clear that the financial stress on the country
and for all the places that look to the Federal Government,
including the Medicare Trust Fund, which is about ready to go
kaput here in four and a half, 5 years, due to high health care
costs and putting too benefits in there. Our elderly depend on
it for their health care. Social Security, it has got about
another 10 or 11 years. We have been paying into that since the
FDR days.
I think this idea of taking care of natural disasters and
doing it in a responsible way also begs the question: When are
we going to get our financial house in order here in D.C.,
generally?
Thank you.
The Chairman. Thank you, Senator Braun. I will turn now to
Ranking Member Scott.
Senator Tim Scott. Thank you, Mr. Chairman. This is a
question for all the panelists. Working with local emergency
management is such a critical component of disaster relief and,
frankly, the response or the coordination.
In an earlier life, Mr. Chairman, I was the Chairman of the
Emergency Operations Center for Charleston County during
hurricanes and natural disasters, and so I spent a number of
24-to 36-hour days in the command center where we had an
opportunity to try to coordinate the response teams' efforts on
behalf of communities before, of course, the hurricanes or
natural disasters happened. We would have meetings every year,
praying and hoping that we did not have to mobilize a team, but
realizing that is always an ``if,'' not a ``when.'' Or, a
``when,'' not an ``if.''
One of the things that I realized during that time was the
importance of having everybody on the same page, whether that
was the voluntary efforts, the law enforcement, the EMS, the
fire, the councils themselves. Then we, in Charleston County,
had 17 different municipalities. We had to have all 17 heads of
government working with the county, plus the volunteer
apparatus and all the fire departments, all the law enforcement
agencies and all the nonprofits that we wanted to be a part of
that process. The importance of that local coordination cannot
be usurped or replaced by a Federal top-down approach to
natural disasters.
My question for the panel is: What are the best practices
voluntary organizations and local emergency managers should
follow to ensure volunteers are included--and I want to
emphasize ``included''--in all phases of disaster management?
That really, from my perspective, means from the beginning. The
beginning is not the day before the disaster. It is all year
long as we all know that we are going to have to face them in
the future.
What are the best practices that we should embrace and be
aware of?
Dr. Spurlock. Yes, thank you. This is Dr. Spurlock. I think
that is an excellent point that you make because really the
planning has to be ongoing. We know that hurricane season ends,
fortunately, in 2 days, on November----
Senator Tim Scott. Yes, ma'am.
Dr. Spurlock. Yes. Our work in terms of increasing our, you
know, preparedness and ability to be able to respond to these
unforeseen disasters is ongoing. As you mentioned, it is
really--I think it is a community, you know, based support
because when disasters ensue it is going to be at the level of
the local and the communities that are going to need to
initially respond to meet the needs of their populations.
I think that is also when it is really critical to have
overall knowledge of the overall health of the various
communities because that has to be taken into consideration
because it will determine more or less the scope of services
that will have to be deployed and also in terms of the disaster
response as well. We know that many of our communities
throughout our Nation exist today in poor health status, and
all of those statistics are readily available to us through the
America's health care rankings. We know in terms of the
various, you know, social determinants of health and how they
can drive more or less a community's ability to be able to
respond to a disaster, so all those have to be taken into
careful consideration.
By bringing all the individual organizations to allow them
to become stakeholders, to have a voice, and then not to
overlook sometimes organizations that can really play a
critical role at the community level, namely, faith-based
organizations. I witnessed this firsthand following Hurricane
Katrina, how those faith-based organizations immediately
stepped up the plate and started to open what we sometimes
refer to as pop-up, you know, type of shelters. That gave
tremendous support, you know, to the community at large.
Sometimes also, overlooking the resources that academic
settings can bring, you know, to the table as well because they
are, you know, embedded in the community. Persons who are
employed in those, you know, organizations have a really good,
you know, mindset and viewpoint in terms of the overall needs
of the communities.
Once we can pull all of those resources together, as we
were able to do as a school of nursing following Hurricane
Katrina, to get involved in that health care for extended
periods of time, we realized that no one institution can go at
it alone. It is really the whole of the community--academic
settings, public and private partnerships. That is incumbent
upon us to garner out resources and to step up when disasters
do hit our communities and also to have an ongoing plan and
dialog.
Senator Tim Scott. Thank you.
Dr. Spurlock. Thank you.
The Chairman. Senator Scott, thank you very much. We will
turn now to Senator Gillibrand.
Senator Gillibrand. Thank you, Mr. Chairman.
Dr. Spurlock, thinking about the dedicated staff who care
for older adults in nursing homes, what is the most critical
piece or lever that we can use to ensure that they are prepared
for the next disaster. What is the best way we can ensure that
the needs of older adults and people living with disabilities
are known and anticipated in a disaster?
Dr. Spurlock. Thank you. I am really so pleased to be able
to participate in this hearing today because it really shines a
national spotlight on this issue.
Of course, nursing homes might oftentimes lack the
resources that are in place in private institutions, other
larger healthcare industries or acute care hospitals may have
access to. I think there is an ongoing need for funding in
terms of resources and for ongoing education for disaster
preparedness, to be able to make decisions regarding evacuation
compared to sheltering in place. These are critical decisions
that must be made in long-term care settings.
I think mainly to support the staff is to give them the
necessary resources in terms of education and preparedness, as
we saw with the COVID-19 pandemic, for the staff to have the
necessary personal protective equipment available to them to be
able to use on a day-to-day basis.
Senator Gillibrand. In the current and escalating climate
crisis, we will continue to see and experience extreme weather
events. Climate change, together with other natural and human
made health stressors, influence our health and well-being in
numerous ways. From the pandemic, our experiences can be vastly
different within the same State, city, and even same house,
depending on a person's age and their physical and mental
health.
We need to do better to support and anticipate how
disasters can affect different groups of Americans and
marginalized Americans, and we can do better by including
people with diverse capabilities and experiences in planning
discussions.
I am proud to support Chairman Casey's Real Emergency
Access for Aging and Disability Inclusion for Disasters Act, or
the REAADI Act, which would really work toward ensuring that
older adults and people with disabilities are involved in the
preparation and response and recovery and mitigation of
disasters.
Dr. Bell, how would a National Commission on Disability
Rights and Disasters help ensure the gaps in inclusive disaster
planning and response and recovery are closed?
Dr. Bell. Thank you so much for that question. I think the
National Commission, which by my understanding will have a
large makeup of people with disabilities, will center the needs
of the disability community and the aging community. I think
the Commission itself is made up of--or, the mandate of the
Commission is to draw from a diverse group of stakeholders,
which is really when we talk about a whole community, what we
really do need is to understand--I understand there is a local
coastal emergency manager that, for example, will be on the
committee versus a non--you know, area--from a noncoastal
region. There is disability advocates and representatives that
are making up the Commission.
I think that it is--the goals of the Commission are
important and needed and will advance inclusive disaster
management.
Senator Gillibrand. Thank you.
Ms. Koerner, thank you for sharing your professional and
lived experience on the importance of including people with
diverse capabilities in the disaster planning process. What are
the significant gaps in inclusive disaster planning response
and recovery that you noticed through your experience? What
resources did you find most helpful?
Ms. Koerner. Thank you so much for that question. Here in
southeastern Pennsylvania, we are part of a really fantastic
team of individuals made up of multiple backgrounds and diverse
capabilities, areas of expertise, called the Southeast Regional
Task Force Access and Functional Needs Subcommittee.
During the pandemic response, during the response post-Ida,
and even back with Isaias, one of the things that we did was
turn to this group of individuals to determine where the gaps
were and make sure that nothing was being left out and really
looking to that group of individuals to make sure that when we
were forming our response and forming our communications, it
was really through a whole community lens.
I think one of the things that we noticed early on was, you
know, a need to improve communication. We worked with a lot of
our community partners to make sure that everything was
accessible from multiple language perspectives, from written
and nonverbal communication perspectives, and making sure that
we were getting the message out through multiple different
sources, so that was something that we saw early on and were
able to respond to specifically because we had individuals with
that background, with that personal experience, and with that
area of expertise.
I really think that the value that individuals from all
different backgrounds that they bring to the community and
bring to this topic really cannot be devalued at all.
Senator Gillibrand. Thank you, Mr. Chairman.
The Chairman. Thanks very much, Senator Gillibrand. We have
three Senators awaiting questions: Senator Rosen, Senator
Blumenthal, and Senator Kelly.
Senator Rosen. Thank you, Chairman Casey, Ranking Member
Scott. It is a really important hearing, and I appreciate
everyone who is here and all the witnesses today.
I want to talk a little bit about something happening in my
State and across the West is extreme heat and wildfires because
around the world and, of course, here in the United States
climate change has worsened and the devastating impacts of
wildfires and extreme heat, particularly in western states like
mine, Nevada, has just been devastating. Already this year, we
have seen over 49,000 wildfires burn over 6.5 million acres of
land, including several recently affecting Nevada, like the
Tamarack and Caldor Fires, which forced residents in parts of
Douglas County to evacuate their homes amid a declared State
emergency.
Worsening wildfires not only pose a serious threat to human
life, to our health, to personal property, to wildlife, and of
course, our seniors, some of the vulnerable. That is why I
recently introduced the Fire Information and Reaction Act. It
is bipartisan legislation that directs NOAA to establish a new
program to improve wildfire forecasting and detection because
more accurate predictions and warnings, they really can protect
lives and livelihoods, not just of Nevadans but for everyone.
Dr. Bell, as someone who has been deployed to provide
clinical nursing care in response to western wildfires, what
can you tell us about what you have seen about the frequency
and severity of the fires as they are impacting our most
vulnerable, of course, seniors, rural Americans, people of
color?
Dr. Bell. Thank you for that question. I have had the
opportunity to deploy to western wildfires and was at the
Paradise, California wildfires, working in a shelter to provide
primary care and emergency care. You know, one important thing
to think about is that these wildfires displace broad swaths of
populations from their homes and from their communities.
I know I have talked a lot about the importance of aging in
place and the importance of staying, you know, in the preferred
living environment, and that is not possible when evacuations
are in order after wildfires. We really have to be thinking
about, for older adults and people with disabilities, how can
we better improve our planning around short notice and no
notice evacuation and sheltering needs, as these needs, we can
expect them to increase in the future.
Senator Rosen. Thank you. I appreciate that. I look forward
to working with you on that, for sure, to be sure we have the
right places to put people in emergency and beyond.
I want to move on to speaking of emergencies and during
disasters, mobile clinics. We know how mobile clinics, and of
course during COVID, what a difference they made.
Dr. Spurlock, you know, your testimony. You discussed how
in the aftermath of Hurricane Katrina Southern University and
local FQHCs, they made use of these mobile health units to
deliver regularly scheduled care to displaced residents,
emergency care and the like. Mobile units have been doing this
for COVID-19, of course, across the country and in my State of
Nevada throughout the pandemic. Susan Collins and I have
bipartisan legislation to provide communities greater access
and flexibility to use Federal funds to deploy mobile health
units, particularly in rural areas and underserved areas of
Nevada and Maine that we have a lot of.
Dr. Spurlock, can you tell us more about the vital role
mobile health units can play in serving seniors, of course,
during a disaster? We know they serve other times. How can we
use these mobile health clinics that play that important role
to deliver health care?
Dr. Spurlock. Yes. Thank you for that question. Little did
we know when our School of Nursing acquired our mobile unit
that we would deploy it in actual hurricane response efforts.
Prior to that, we were already within the community, trying to
reach our vulnerable populations who otherwise would not have
accessibility to health care services. We had already engaged
in outreach to rural areas to seniors, to homeless populations,
to battered women's shelters, and we had a health care
infrastructure already in place that would allow us to be able
to have a rapid response to meet the needs of the hurricane
evacuees.
Mobile units are really irreplaceable because the mobile
units, of course, are clinics on wheels. When a clinic is on
wheels, you can actually deploy it to diverse settings and
actually go to where the health care needs are.
Those mobile units, when they are staffed with health care
providers, in our instance, we used family nurse practitioners
and an advanced practice nursing model in collaboration with a
family practice physician and also called upon our many years
of partnerships with other healthcare agencies and
organizations throughout the community, many of whom served the
needs of older adults and persons with disabilities and, as you
mentioned, the federally Qualified Healthcare Centers. We could
bring all of those services to what I would refer to as a one-
stop shopping, so to speak.
They were all deployed into, you know, central areas to
where the hurricane evacuees would have immediate access to our
services and then also to promote continuity of care to reduce
the likelihood of fragmentation and the hurricane survivors
could also receive the services and follow-up care at the same
site.
Thank you.
Senator Rosen. Well, thank you. I really think that mobile
health care, telehealth, whether it is an emergency or not,
they really provide and expand access and improve and save
lives, so thank you.
My time is over. Thank you, Mr. Chairman.
The Chairman. Senator Rosen, thanks very much. I will now
turn to Senator Blumenthal.
Senator Blumenthal. Thank you very much, Mr. Chairman. I
want to thank all our witnesses for their testimony today, very
helpful and informative.
In Connecticut, we have 845,000 adults over the age of 60.
We have serious storms, like every other State in the country,
often causing flooding, transportation failures, roads
devastated. We often have these superstorms, which are becoming
the new normal, that can be devastating for seniors, causing
them to evacuate and then even more depressing when they try to
return to their homes because there is serious property damage,
everything from downed trees to holes in roofs and the litany
of problems that can be caused to homes.
I am grateful to Chairman Casey for the Disaster Relief
Medicaid Act, which I have co-sponsored, which ensures that
individuals eligible for Medicaid who are forced to relocate
during a disaster are able to continue access to Medicaid
supported services.
We focus a lot on the service aspect of disaster relief,
but I want to ask our witnesses about the property aspects and,
most particularly, access to property insurance, the money that
is needed to repair the roofs and the windows and remove the
trees and make homes again livable.
I have found many of our elderly have trouble accessing
insurance, more trouble than others, because, they number one,
may not keep records that are necessary for accessing
insurance, number two, they can be confused by the litany of
criteria and technical requirements, and number three, they may
not have the access to communication, whether it is internet or
cell phones, especially if cell phone service is down, that
others may because they can do it from work.
Let me ask all of our witnesses whether you think that
property insurers and insurance needs to be made more
accessible, more easily available to seniors in the wake of
these natural disasters.
Dr. Bell. I will take that one. I think that is a great
question that comes with a lot of complexity.
Of course, we want our most vulnerable of our citizens to
have the resources they need to live through a disaster and to
return to their homes and be safe. We also have a lot of
complexity involved in how we can support individuals through
Federal funding, to access Federal funding to recover from
disasters. I think that is a key point to think about is how
can we reduce some of the complexity around insurance and
access to insurance and also accessing the benefits that
insurance payments provide.
I also think that--you know, that is a fairly complex
question to even tackle and one that needs, you know, probably
its own hearing if I do say, you know, when we think about the
National Flood Insurance Program and the challenges that
individuals have in living in, you know, communities affected
by climate change and accessing insurance in the future.
Senator Blumenthal. It may be worth its own hearing, but I
really think it is a vital part of this picture because the
seniors or elderly trying to go back to where they live, and
often they have lived there for a very long time and they have
emotional connections, often find it very difficult to deal
with insurance companies. Trying to aid them, as my office
often does, is also made more difficult because they may not
have prepared for this kind of disaster as long as they may
have lived in their homes.
They deserve relief from the property insurers. They need
and deserve the reimbursement for making their homes livable
again, but often the insurance companies fail to provide the
kind of aid that they should.
I welcome your interest, and I hope the other witnesses are
interested as well.
Thank you, Mr. Chairman.
The Chairman. Thank you, Senator Blumenthal.
I want to thank everyone who made this hearing possible
today. I am going to start with Ranking Member Scott and his
team as well as my staff and so many others who made it
possible. On top of that list are the witnesses who appeared
today, Dr. Bell, Dr. Spurlock, Mr. Creamer, and Ms. Koerner,
for their testimony and for both the personal experiences they
bring to bear on these issues as well as their professional
experience, and we are grateful they are with us today.
As we have heard today, natural disasters are increasing in
both frequency and severity. The COVID-19 pandemic has shown us
that we need to prepare for the compounding effects of both
disasters and public health emergencies. People with
disabilities and older adults are disproportionately at risk
for negative health outcomes and death due to these disasters.
We know that. We have got to do something about that, and these
disparities must be remedied. I think we have made some
progress today in recommending some of those remedies.
We need to prioritize the voices of seniors and people with
disabilities, especially from communities that are too often
left behind. The REAADI for Disasters Act legislation I have
introduced will mandate that people with disabilities and older
adults will be included in all phases--all phases---of disaster
management and provide resources for communities to plan more
inclusively. That is what that bill will do.
Our witnesses' research that they have summarized today
shows that the majority of seniors and people with disabilities
prefer to live in their own homes, in their own communities,
and emergency planning should reflect that preference.
I want to turn just to the--finally to the mechanics of our
hearing in addition to reiterating our thanks to all the
witnesses for contributing both their time and their expertise.
If any Senators have additional questions for the witnesses or
statements to be added, the hearing record will be kept open
until next Monday, November 29th.
Ranking Member Scott was pulled away a couple of times to
other hearings. He will submit a statement for the record,
which will be made part of the hearing record.
The Chairman. With that, we want to thank all who
participated today, and this will conclude our hearing.
[Whereupon, at 11:20 a.m., the Committee was adjourned.]
CLOSING STATEMENT OF SENATOR
TIM SCOTT, RANKING MEMBER
Thank you Chairman Casey and all of our witnesses.
Today we heard from true heroes - experts and local leaders
on the front lines during disasters.
We learned that while we are making progress, there are
still gaps that remain in our nation's disaster mitigation,
preparedness, response and recovery, especially for older
Americans and Americans with disabilities.
When an emergency strikes, it is the local first responders
who are the first on the scene.
We must do everything we can to support and empower local
communities in their most vulnerable times, especially for
their most vulnerable citizens.
For South Carolina specifically, and many other coastal and
southern regions, I am working to: 1) Improve flood mitigation,
2) Allow locally owned restaurants and nonprofits to
participate in programs to feed disaster victims, and 3) Ensure
Black homeowners who lack clear legal title to their property
have equal access to FEMA disaster recovery funds.
We must build on previous bipartisan legislation to help
older Americans and Americans with disabilities before, during,
and after disasters.
I look forward to working in a bipartisan manner to make
this happen.
Again, thank you to everyone here today.
Your testimonies help us to do our work to better support
older Americans.
I yield back.
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APPENDIX
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Prepared Witness Statements
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Questions and Responses for the Record
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