Every September, National Preparedness Month brings focus to disaster planning and getting ready for emergencies. This year’s theme says it best – we should aim to be “Prepared, Not Scared.”

Of course, even with the best plan, a catastrophic storm, or wildfire, or any other kind of emergency situation can still be very scary. And no amount of preparation will completely eliminate the stress of evacuating your home. But with a comprehensive, individualized emergency plan, no one should have to be afraid for their life, health, or independence.

Emergency preparation is important for everyone. However, older adults and people with disabilities often face additional challenges during emergencies because of health issues, mobility challenges, and use of devices that rely on power. Those individual circumstances make having a plan absolutely critical.

Whether you’re updating your existing plan, or creating one for the first time, asking yourself these questions can help frame what you need to think about:

• What kinds of disasters are most likely to affect your community?
• How might a disaster affect you?
• Is evacuation a likely possibility? Where would you go?
• Could you make it on your own for at least three days? What would you need?
• What problems would you experience if you did not have power for 8 hours? 24 hours? A week?

Every plan will be different, based on individual needs. However, everyone should have an emergency kit that includes food, water, and at least a week of medications. Include this this card, completed with your vital medical information, and if you have a communication-related disability, this card can help first-responders assist you in the way that is best for you. Include a flashlight and extra batteries, and first aid supplies. Ready.gov has an outstanding emergency kit checklist that will help you think of everything you need. (For additional ideas, see this checklist for kids.)

Other things to think about when you’re putting together your plan include:

• Which shelters are able to accommodate your individual needs? If possible, be ready to tell first responders, so that you are able to evacuate with your family, service animal, caregiver, personal assistant, and assistive technology devices and supplies.
• Plan ahead for accessible transportation. Work with local services, public transportation or paratransit to identify your options, and include contact information in your emergency kit.
• If you are dependent on dialysis or other life-sustaining medical treatment, note the location and availability of more than one facility.
• If you use in-home medical equipment that requires electricity, talk to your health care provider about how you can prepare for a power outage.
• If you use an augmentative communications device or other assistive technologies, plan for how you will communicate with emergency personnel if your equipment is not working -- this might include laminated cards with phrases, pictures or pictograms.
• If you use assistive technology, make sure your plan considers what you will need to take them with you. Have extra batteries available. To simplify replacing equipment that is lost or destroyed, your emergency kit should include model information, where the equipment was purchased, and how it was paid for (Medicaid, Medicare, private insurance, etc.).
• Don’t forget to include your service animals and pets in your planning. Have an emergency kit that includes food, water, medicines, and first aid supplies for them, too.

Finally, consider the help you may need to execute your emergency plan. Create a support network of friends, family and others who can assist you during an emergency, and share your disaster plans with them.

National Preparedness Month also is a great time for communities to make sure their disaster response and recovery plans consider the needs of older adults and people with disabilities. Across the nation, the community-based organizations that form the aging and disability networks are providing critical expertise that is resulting in emergency plans that are more inclusive and accessible than ever before. If you are working to improve your community’s plan, I encourage you to bring the networks in as partners.

Whether you’re working on your personal emergency plan, are part of a community planning team, or are supporting older adults and people with disabilities in the community (or all of the above!), ACL’s website can point you to many resources available to help.

Planning for disasters is everyone’s business, and together, we can make sure everyone is included.

Meet Roxanne Price.  When she isn’t traveling around the world, spending time with family and friends, reading, or gardening, she works with people teaching them about Self-determination and Self-Directed Supports.  She has always been very passionate about Self-Determination and Self-Direction.  She encourages people to ask questions and be clear about what you want.  We’re so fortunate to have Roxanne as a member of the Network!  

What's your story?  Tell us a little bit about yourself.

Roxanne is very passionate about Self-Determination and promoting Self-Directed Supports! She explains that it has been her primary focus since 1998, when she was hired as the Self-Determination Project Coordinator in La Crosse County back when Family Care was first getting started. La Crosse County was one of the five Family Care pilot counties in Wisconsin.  She participated in many meetings and discussions with self-advocates, their allies and many others to make sure that Managed Care in Wisconsin emphasized personal choice, responsibility and empowerment.  “People didn’t like the idea of being “managed” and we didn’t want the program to become an impersonal, “one size fits all” approach to assessing needs and providing supports for people,” she says. Since her position was funded through a Robert Wood Johnson grant, when the grant ended, she was hired as a Care Manager with the Family Care Program in La Crosse where she continued my involvement in Self-Determination and Self-Direction. In 2008, the La Crosse Program expanded to include seven additional counties and they became known as Western Wisconsin Cares. She says that even though she misses the ongoing connections that she had when she was a Care Manager, she was excited to be hired as the Self-Directed Supports Coordinator for the eight county regions.  So, for the past 11 years, she has been focusing exclusively on Self-Determination and supporting the successful use of Self-Directed Supports. Two years ago, three Family Care Organizations merged into the organization that is now known as Inclusa. “I think we are very fortunate to have a dedicated SD/SDS team that provides education and support throughout our service regions and I love being able to follow my passion with others who feel the same way,” she exclaims! 

How are you involved with self-determination?

Roxanne is currently one of the SD/SDS Managers at Inclusa. Inclusa is one of Wisconsin’s Family Care Organizations and covers much of the state.  She helps members (clients) and their Care Management teams learn about Self-Determination and Self-Directed Supports, and she helps them decide how to set it up so it best fits their individual strengths and needs. Also, when there are problems or concerns, she gets involved to help figure out the best solutions. 

Why did you join the SD Network?

Roxanne says that she is always looking for the latest information about Self Determination and Self-Directed Supports and she knew that the SD Network would be a good resource!  

What tip or resource would you like to share with people who want to be more self-determined?

Roxanne encourages people to be clear about what you want and don’t be afraid to ask questions to be sure you understand things!  She says to try to be respectful even if you disagree with what someone says and ask for support when you need it. “Finally, it’s ok to make a mistake – sometimes it’s the best way we learn! Nobody is perfect,” she says! 

What are some of your hobbies?  

Roxanne loves to read! True stories are especially inspiring to her. She also really enjoys taking pictures of people, places and things.  In the spring, she likes to work in the garden – even pulling weeds!  She explains that her friends and family are very important to me and she spends a lot of time with them. Recently, she has gotten brave enough to travel to other countries and that has really been exciting her!

 ***We love hearing the views and opinions of Network members. We need to mention that the views and opinions expressed on this site are those of the person who is sharing them. They do not necessarily reflect InControl Wisconsin or any of our supporters and funders.

“It takes a village to raise a child.”  It’s a saying commonly used when talking about supporting a child who has disabilities.  Whether it’s before the child is even born, right after birth, or years later, when parents learn that there’s something “wrong” with their child, panic strikes.  A million questions go through their heads.  Getting that initial diagnosis and prognosis is often life-changing for the entire family.  After the shock wears off, it’s often realized that, although it’s probably different than originally planned, life goes on.  It’s realized that there are special people in the world to help guide you on this journey of life.  Many times, special relationships are formed and these amazing people are lifelong friends.  They may not be soccer coaches or dance moms you once dreamed of being friends with; instead, these people are therapists, paraprofessionals, and other families with special needs that have supported you along the way.

As I’ve explained in other entries, complications during birth caused brain damage resulting in my diagnosis of cerebral palsy.  Though I wasn’t officially diagnosed until I was three months old, because of the lack of oxygen I had at birth, my parents knew immediately I’d likely have some limitations.  At eight months old, I started physical therapy.  I went to a private therapy place in Oshkosh.  Because of the dynamics of this place, the physical therapist and some of her clients were able to form a special bond.  There were five or six of us around the same age with similar circumstances.  It was a pretty unique situation.  The families were able to help each other with different resources and things.  A couple of us were on United Cerebral Palsy (UCP) telethons together.  There was a speech therapist and occupational therapist in the facility that some of us saw.  I saw the physical therapist until I was over 16 years old.  We became like a big family.  We supported each other through life’s ups and downs.  Thanks to Facebook, many of us have reconnected and kept in touch.  It’s very neat to see where we all ended up.  Looking back, it’s amazing to see how far we’ve all come.  I recently met the physical therapist for dinner.  It was really fun to catch up and fill her in on what I’m doing.  It’s partly thanks to her, I am where I am today.

Another group of those special people are the therapists I had in school.  I’ve explained before that throughout my school years I had physical, occupational, and speech therapies.  The frequency of these therapies depended on my needs each year.  I had some great physical and speech therapists throughout the years.  I still occasionally keep in touch with some of them and they love hearing how well I’m doing.  I was also very fortunate to have the same occupational therapist from Early Childhood through my senior year of high school.  Again, she helped my family and I navigate through school system.  She was such an important key to my success.  In fact, when I do presentations or participate in board meetings, I often think of her because we worked for years and years with different assistive technology for my communication.  I have her on Facebook and sometimes I send her a message just saying “Hey I’m doing this and this—it’s because of all your help back in the day I’m able to do these things.”

Paraprofessionals are another group of a very special people in life.  Again, in past entries I’ve explained that thanks to the amazing paraprofessionals I had, I was able to succeed in regular education classes starting in kindergarten on.  These ladies helped me with whatever I physically needed to succeed in the regular class.  Everything from getting my jacket on and off, to feeding and toileting, to getting books out and taking notes, to setting up my computer or being my scribe for tests…  the list goes on and on.  I was truly blessed to have many outstanding paraprofessionals in my life.  Because they worked closely usually one-on-one with me every day at school, I became pretty close with most of them and keep in touch with them to this day.  I was incredibly blessed to have the same main assistant for eleven years.  Obviously, we became very close and remain close to this day.  We consider each other family.  We’ve become friends with each other’s extended families.  It’s definitely a very special relationship.  I think everybody in both of our lives know that we wouldn’t be the same people we are if we hadn’t met!  It was definitely meant to be!

There are many other special people in my life, but these relationships probably wouldn’t have happened if I didn’t have the unique circumstances I do.  Many people my age have friends from moms’ groups, friends from their kids’ activities, friends from a volleyball league or other activities.  While I’ll probably never friends from situations such as those, I’m incredibly fortunate to be friends with so many people who made such a profound impact on my life.  It really does take a village, and I’m truly blessed to have an outstanding village of people who continue to support me! 

***The views expressed here are strictly those of the author and do not necessarily reflect those of InControl Wisconsin, the Network or any of our sponsors.

Assistive robots are growing in popularity.  They are being used to assist people with disabilities, the elderly, toddlers, and industrial workers perform physical tasks.  The aim of assistive robotics is to develop robotic aids for supporting people living independently and those who have degenerative limitations, such as elderly and people with disabilities.  The increase in funding worldwide for research on assistive robotics is expected to fuel the growth of the assistive robotics market during the forecast period.

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ACL has released a new Issue Brief on Assistive Technology. Assistive technology (AT) includes software, devices, equipment and products that improve the functioning of individuals of all ages with disabilities. Assistive technology can affect a person’s well-being by improving their ability to walk, eat, bathe, communicate, see, speak and live independently. Technologies also can help address social isolation and improve quality of life by assisting people with communication, mobility, and other daily activities.

This issue brief discusses:

1) the important role of assistive technology in helping people of all ages with disabilities live full and independent lives in their communities; and

2) certain sources of public funding for the technology, including Medicare, Medicaid, and programs that the Administration for Community Living (ACL) manages.  

View the Assistive Technology Issue Brief

The Wisconsin Family and Caregiver Support Alliance(WFACSA) is accepting nominations for our first ‘Thank You for Being A Friend’ award, honoring a notable individual, agency, employer who made a significant impact in a family caregiver’s day, week, year, or life!  Family caregivers can nominate a person, agency, employer of their choosing that has had a significant impact on them.  WFACSA will select one winner in each of the three following categories:

• Supportive Employer
• Supportive Agency
• Supportive Individual

As a family caregiver, do you have someone, whether it be a friend, neighbor, family member, doctor, nurse, care worker, or employer that has made a significant impact on your role as a caregiver?  Maybe someone finally asked how you are doing and whether or not you have the supports you need?  Maybe someone offered to care for your loved one so you could get some sleep and it meant the world to you?  The Wisconsin Family and Caregiver Support Alliance wants to recognize and honor those that support you, the family caregiver.  

To submit a nomination, please complete the form below by September 15, 2019. Nominations will be reviewed by the WFACSA Steering Committee based on the impact as identified by the family caregiver/nominator.  (The Conference Planning Committee reserves the right to present none or multiple awards in any of the categories.)

To submit a nomination, you can Click here to complete a Nomination Form online, or Click Here to download a hard copy to complete and email it back to us at wfacsa@gmail.com.

Deadline to submit a nomination is September 15, 2019. 

Winners will be recognized at the 2019 Self Determination Conference, October 15th at the Kalahari Resort and Conference Center in the Wisconsin Dells.

The Administration for Community Living is seeking input from stakeholders including academic and research universities, area agencies on aging (AAAs), State Units on Aging (SUAs), Aging and Disability Resource Centers, Centers on Independent Living, and non-profit organizations on assessing changes in cognitive health among homebound older adults. Cognitive health – which falls under the broad, umbrella term of brain health – refers to a person’s capacity to “remember, learn, plan, concentrate, and maintain a clear, active mind” [1]. Homebound older adults – when compared to non-homebound older adults – exhibit greater declines and may experience declines in cognitive health that can affect their quality of life and functional independence.

We are seeking input and responses to the following list of questions:

1. What are the characteristics of older adults for whom you conduct cognitive screening tests?
2. What screening test and/or (psychometric) instruments (e.g. tests of recall, attention, processing speed, etc.) does your organization use to measure cognitive health?
3. What is the length and format (e.g. in-person, paper-and-pencil, telephone, web-based, tablet, smartphone, etc.) used to administer these screening tests and/or instruments to the population of older adults you test?;
4. What is the frequency with which your organization administers these tests and/or instruments and the duration over which cognitive health is monitored?;
5. What is your estimate of the general cost per person for administering the test or instrument?
6. What happens when changes are detected in a person’s cognitive health and how is this information used?; and
7. What are the intended health outcomes (e.g., screening for a research study, early identification and detection, improvement through exposure to new interventions, reductions in re-hospitalization, etc.) sought from monitoring cognitive health over a period of time?

Purpose:

The purpose of this Request for Information (RFI) is to gain feedback and input on existing efforts to monitor status changes to cognitive health in the homebound older adult population from individuals or groups including – but not limited to – those in the academic and research communities, Area Agencies on Aging (AAAs), State Units on Aging (SUAs), Aging and Disability Resource Centers, Centers for Independent Living, and nonprofit organizations among others.

This RFI is for information and planning purposes only and should not be construed as a solicitation or as an obligation on the part of the federal government or the Administration for Community Living. ACL does not intend to make any awards based on response to this RFI or to otherwise pay for the preparation of any information submitted to or for the government’s use of such information.

Background:

According to cross-sectional data collected in 2011 by the National Health and Aging Trends Study, approximately 2 million (5.59 percent) of the older adult Medicare population were completely or mostly homebound [2]. A number of studies comparing the health profiles of homebound older adults – as compared to non-homebound older adults – consistently report that homebound older adults tend to be older in age, have multiple chronic conditions, and more frequently use healthcare services including emergency department visits [3].

Underscoring the potential importance of tracking cognitive health among the homebound older adult population is recent evidence finding that self-reported memory difficulties are a strong predictor of the homebound status of older adults [3] and evidence that screening tools and measures may prove useful in identifying those who may be experiencing cognitive decline or dementia despite not having a diagnosis [4].

What We Hope to Learn From this Invitation:

ACL is issuing this RFI to obtain input on existing efforts to monitor status changes in cognition in the homebound older adult population. This information will help ACL better understand what services, supports, and innovations are needed to inform interventions and/or policies to address declines in cognitive health that occur over time in the homebound older adult population.

References:

• https://www.nia.nih.gov/health/cognitive-health-and-older-adults" target="_blank" rel="noreferrer noopener">https://www.nia.nih.gov/health/cognitive-health-and-older-adults; https://brainhealth.nia.nih.gov/
• Ornstein, Katherine A et al. “Epidemiology of the Homebound Population in the United States.” JAMA internal medicine vol. 175,7 (2015): 1180-6.
• Musich, Shirley, et al. "Homebound older adults: Prevalence, characteristics, health care utilization and quality of care." Geriatric Nursing 36.6 (2015): 445-450.
• Setter, S., Neumiller, J., Weeks, D., Borson, S., Scanlan, J., & Sonnett, T. (2009). Screening for undiagnosed cognitive impairment in homebound older adults. The Consultant Pharmacist®, 24(4), 299-305.

Addresses:

Comments should be submitted electronically to Dr. Vijeth Iyengar (vijeth.iyengar@acl.hhs.gov) with “RFI-Cognitive Health Status Changes Homebound Older Adults” in the subject line.

For Further Information Contact

Dr. Vijeth Iyengar (vijeth.iyengar@acl.hhs.gov) with “RFI-Cognitive Health Status Changes Homebound Older Adults” in the subject line.

It would be helpful to this RFI and ACL if you could structure your response in the following way:

• Name of respondent
• Preferred contact email
• Organizational affiliation(s)
• Response to questions in the order they appear in the summary section of this RFI

Comment Due Date:

To be assured consideration, comments must be received by 5 pm EST on September 20, 2019.

Three U.S. Senators have introduced “The Exercise and Fitness For All Act” to improve access to fitness equipment and classes for people with disabilities.  The bill would promote the provision of exercise or fitness equipment, and exercise or fitness classes and instruction, that are accessible to individuals with disabilities.  It would have guidelines and regulations for fitness service providers specifying the accessible equipment and classes necessary to  ensure that people with disabilities can obtain the benefits  of physical activity and  fully participate in the services offered by the fitness provider.  

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The Department of Health Services has been granted an extension which pushes the Electronic Visit  Verification (EVV) implementation date back into 2020. The federal law would have gone into effect January 1, 2020, requiring all personal care and supportive home care workers to verify their time/location through an electronic system (smart phone, etc.).  

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For the third time this year, additional funding will keep alive a federal program that moves individuals with disabilities from institutions into the community.  Legislation signed this month allots another $122.5 million for Money Follows the Person which is a Medicaid program provides states with funding to pay for employment supports, housing and other services so that people with disabilities can transition from nursing homes and other institutional facilities to homes in the community.  The latest action will keep the program running through the end of this year, but advocates say it's operating at a  minimum level.

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