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National Commission on Children and Disasters: 2010 Report to the President and Congress

Public Health Emergency Preparedness

This resource was part of AHRQ's Public Health Emergency Preparedness program, which was discontinued on June 30, 2011, in a realignment of Federal efforts.

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9. Sheltering Standards, Services, and Supplies

Recommendation 9.1: Government agencies and non-governmental organizations should provide a safe and secure mass care shelter environment for children, including access to essential services and supplies.
  • Implement national standards and indicators for mass care shelters that are specific and responsive to children.
  • Integrate essential age-appropriate shelter supplies for infants and children into shelter planning and fund the addition of child-specific supplies to caches for immediate deployment to support shelter operations.
  • Implement common standards and training, including standards for criminal background checks, to mitigate risks unique to children in shelters such as child abduction and sex offenders.

During disasters, children and families must be assured a safe and secure shelter environment. Shelters are operated by the American Red Cross (ARC), other National Voluntary Organizations Active in Disaster (NVOAD) member organizations, faith-based organizations, and State and local governments under agreed upon standards and protocols. While the Federal Emergency Management Agency (FEMA) does not operate shelters or have the authority to enforce shelter standards, FEMA does provide guidance and reimbursement for eligible sheltering expenses under the Stafford Act.

In its Interim Report, the Commission determined that a more comprehensive body of information was needed to inform emergency planners, shelter managers, and staff about the needs of children in critical areas related to shelter design, supplies, and safety.329 The ARC worked with the Commission, FEMA, and other partners to develop guidance for shelter managers and staff. The guidance document, Standards and Indicators for Disaster Shelter Care for Children,330 was distributed to ARC chapters and adopted by the NVOAD Mass Care Committee in 2009.331-332

Disaster shelters that opened during the September 2009 floods in Georgia demonstrated an increased awareness of the need to have child-appropriate supplies and expertise on hand.333 The spring 2010 flooding in Nashville, TN provided another opportunity to test the standards and indicators. Following visits to ARC shelters, the Commission noted that some revisions to the standards were needed, particularly to address the need for folding, portable cribs and playpens in shelters.334 An updated version of Standards and Indicators for Disaster Shelter Care for Children is included in Appendix E.

The Commission also collaborated with ARC, FEMA, the American Academy of Pediatrics, and Save the Children to develop a list of age-appropriate shelter supplies for infants and toddlers (Appendix F). The document provides guidance to shelter managers and staff on essential shelter supplies for children (e.g., formula, diapers, and baby food). FEMA incorporated the shelter supply list into preparedness grants guidance and other internal planning documents and indicated that the supplies are cost-reimbursable.335 In addition, FEMA identified the best methods for Federal responders to rapidly distribute these items to an affected area if requested.336 Such actions include entering into purchasing agreements with vendors to have these supplies ready for express shipment in the event of an incident.337 FEMA used the document as a guide for procuring supplies for evacuees waiting to depart Port Au Prince Airport following the 2010 earthquake in Haiti.338

Currently, elements of both guidance documents are being considered for incorporation into other shelter planning and assessment tools developed by FEMA, the Department of Health and Human Services (HHS), ARC, and other Federal and non-Federal partners. In addition, FEMA has a Pre-Scripted Statement of Work with the HHS Administration for Children and Families to conduct human services shelter assessments. The assessments were modified to include components of the shelter standards and indicators guidance, and the assessment teams will provide assistance to shelter operators in meeting the needs of children.

A corollary concern is the collection of information on the number of children in shelters, which normally is not available because most shelter registration forms do not include age categories. Additionally, shelter operators generally use a "midnight head count on pillows" method to count individuals, which does not consider age or people who use shelter services but do not reside in shelters overnight. Data collection on children and families in shelters would improve shelter resource management and delivery of necessary services to shelter populations. In response to the Commission's concerns about the lack of data collection on children in shelters, FEMA's National Shelter System will be modified to capture information on the number of children within specific age brackets,339 thus greatly improving the system's ability to support the needs of children and families. These age breakouts are anticipated to be included in all shelter guidance documents under development.

The safety and security of children in shelters is of paramount concern to the Commission. The Interim Report therefore included a recommendation that protocols be established that will ensure children are protected against the threat of neglect, abduction, and sex offenders.340 At a minimum, all shelter workers should be trained to identify and address suspicious and inappropriate activity. Available resources include the National Resource Center for Child Protective Services' curriculum and trainer's guide Preventing Child Abuse and Neglect in Disaster Emergency Shelters.341 FEMA also is developing health and safety educational materials for parents and families to better safeguard their children in a shelter environment. Safety and security may also be enhanced by conducting appropriate criminal history background checks on all shelter workers. Most NVOAD members have systems in place for performing background checks on their volunteers, but there are no consistent policies or guidelines. The Commission urges the NVOAD to develop points of consensus and cooperative standards for performing background checks, particularly for volunteers who provide care to children in shelters.

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