Fast Facts

How did older people or those with disabilities fare immediately after Hurricanes Harvey, Irma, and Maria?

Emergency managers and others told us it was sometimes difficult to locate these survivors and provide the help many needed to find food, medicine, and oxygen. Further, FEMA's application for assistance contained disability questions that were easily misinterpreted. This may have led to fewer people reporting their disabilities—making it more difficult to help those in need.

FEMA has begun a new approach to helping people with disabilities. We recommended the agency clarify its application and take other actions.

This disability nonprofit organization facility in San Juan, Puerto Rico, suffered damages in Hurricane Maria.

Outdoor space between two buildings littered with materials from the buildings.

Outdoor space between two buildings littered with materials from the buildings.

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What GAO Found

A range of officials from entities that partner with the Federal Emergency Management Agency (FEMA)—including states, territories, localities, and nonprofits)—reported challenges providing assistance to individuals who are older or have disabilities following the 2017 hurricanes. For example, officials said that many of these individuals required specialized assistance obtaining food, water, medicine, and oxygen, but aid was sometimes difficult to provide. Officials in Puerto Rico and the U.S. Virgin Islands cited particular difficulties providing this assistance due to damaged roads and communication systems, as well as a lack of documentation of nursing home locations.

Based on GAO's analysis of FEMA data and interviews with FEMA officials and stakeholders, aspects of the process to apply for assistance from FEMA after the 2017 hurricanes were challenging for older individuals and those with disabilities. According to stakeholders and FEMA officials, disability-related questions in the registration materials are confusing and easily misinterpreted. For example, FEMA's registration process does not include an initial question that directly asks individuals if they have a disability or if they would like to request an accommodation for completing the application process (see figure below). While FEMA has made efforts to help registrants interpret the questions, it has not yet changed the language of the questions to improve clarity. As a result, individuals with disabilities may not have requested accommodations or reported having disabilities, which may have hindered FEMA's ability to identify and assist them.

Sequence of Disability-Related Questions in FEMA's Registration Process

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FEMA did not establish objectives before implementing its new approach to disability integration, which includes adding new disability integration staff in the regions and decreasing the number of disability integration advisors deployed to disaster sites. Without documented objectives for the new approach, regional leadership across the nation may implement changes inconsistently. In addition, the new approach shifts the responsibility for directly assisting individuals with disabilities to all FEMA staff. FEMA has taken some initial steps to provide training on the changes; however, it has not established a plan for delivering comprehensive disability-related training to all staff who will be directly interacting with individuals with disabilities. Developing a plan to train all staff would better position FEMA to achieve its intended goals and better equip deployed staff to identify and assist these survivors.

Why GAO Did This Study

Three sequential hurricanes—Harvey, Irma, and Maria—affected more than 28 million people in 2017, according to FEMA. Hurricane survivors aged 65 and older and those with disabilities faced particular challenges evacuating to safe shelter, accessing medicine, and obtaining recovery assistance. In June 2018, FEMA began implementing a new approach to assist individuals with disabilities.

GAO was asked to review disaster assistance for individuals who are older or have disabilities. This report addresses (1) challenges FEMA partners reported in providing assistance to such individuals, (2) challenges such individuals faced accessing assistance from FEMA and actions FEMA took to address these challenges, and (3) the extent to which FEMA has implemented its new approach to disability integration.

GAO analyzed FEMA data and reviewed relevant federal laws, agency policy, and federal frameworks. GAO also interviewed state, territorial, local, and nonprofit officials in Florida, Puerto Rico, Texas, and the U.S. Virgin Islands; FEMA officials at headquarters, in regional offices, and deployed to disaster sites; and officials at relevant nonprofit organizations.

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GAO is making seven recommendations to FEMA, including that it establish new registration questions, objectives for its new disability integration approach, and a training plan for FEMA staff. The agency concurred with all but one of the recommendations.

Recommendations for Executive Action

Agency Affected Recommendation Status
Federal Emergency Management Agency The FEMA Administrator should develop and publicize guidance for partners working to assist individuals who are older or have disabilities for requesting data and working with FEMA staff throughout the data sharing process to obtain Individual Assistance data, as appropriate. (Recommendation 1)
DHS agreed with this recommendation and has plans to address it. Specifically, FEMA is developing new, enhanced templates, policies and guidance for field staff to facilitate data sharing with states and other partners. The agency also reported that it is expanding its Open FEMA datasets to provide more autonomous, self-service sharing of aggregated data to fulfill partner data needs when personally identifiable information data is not required. FEMA plans to publish data sharing guidelines on its web site by March 31, 2020 on how to obtain FEMA data to best service individuals who are older or have disabilities.
Federal Emergency Management Agency The FEMA Administrator should implement new registration-intake questions that improve FEMA's ability to identify and address survivors' disability-related needs by, for example, directly soliciting survivors' accommodation requests. (Recommendation 2)
Closed - Implemented
DHS agreed with this recommendation. The agency plans to continuing improving its registration intake questions related to identifying disaster-related loss to disability-based equipment and services. They will also work to assess the demographic factors that represent the percentage of survivors positively answering registration questions regarding the need for assistive support. Analyzing these data will help FEMA assess whether the recent addition of help text language within registration intake improved the number of survivors who positively answer registration questions regarding the need for assistive support. The analysis will also help them determine if the changes to intake questions are needed to better identify and address survivors' accessibility-related needs. In May 2019, FEMA began using revised registration-intake questions that directly asked registrants if they had a disability. According to FEMA's own analysis, the percentage of registrants that identified as having a disability-related need increased substantially after implementing the revised questions.
Federal Emergency Management Agency The FEMA Administrator should improve communication of registrants' disability-related information across FEMA programs, such as by developing an alert within survivor files that indicates an accommodation request. (Recommendation 3)
FEMA disagreed with this recommendation, noting that it lacks specific funding to augment the legacy data systems that capture and communicate registration information. Also, FEMA began a long-term initiative in April 2017 to improve data management and exchange, and improve overall data quality and standardization. The agency expects the initiative to include the development of a modern, cloud-based data storage system with a data analytics platform that will allow analysts, decision makers, and stakeholders more ready access to FEMA data. After the completion of this initiative, FEMA expects that efforts to share and flag specific disability-related data will be much easier. Our recommendation, however, is not solely focused on system changes: other cost-effective ways may improve communication of registrants' disability-related information prior to implementing the system upgrades. For example, as noted in the report, FEMA officials handling different stages of the disaster assistance process may overlook disability-related needs recorded in the case file notes. FEMA could revise its guidance to remind program officials to review the notes to identify whether there is a record of any such needs. As FEMA moves ahead with its data improvement initiatives, we encourage it to consider and ultimately implement technology changes, such as developing an alert within files that indicates an accommodation request. Such improvements would be consistent with the recommendation and help improve communication across FEMA programs.
Federal Emergency Management Agency The FEMA Administrator should establish and disseminate a set of objectives for FEMA's new disability integration approach. (Recommendation 4)
Closed - Implemented
DHS agreed with this recommendation and, in the year following the issuance of GAO's report, took a number of actions to address it. Specifically, FEMA's Office of Disability Integration and Coordination (ODIC) published its 2019-2022 Strategic Plan in May 2019, which established strategic objectives to frame its approach to disability integration. In November 2019, ODIC published a Continuous Improvement Action Plan that laid out findings indicating nine areas for improvement, based on findings from surveys of key stakeholders about the new disability integration model. To address these areas for improvement, the plan included 55 action items that align with ODIC's Strategic Plan. In February 2020, ODIC distributed the action plan to all of FEMA's Regional Administrators, highlighting the plan's objectives for training, information sharing, and communication intended to improve the Disability Integration cadre's interactions with field leadership and other staff. Finally, in January 2020, ODIC updated performance goals for all deployable Disability Integration cadre members. The new performance goals were aligned with ODIC's Strategic Plan and the new disability integration approach, and are intended to standardize program delivery and serve as a measure of success for the new approach.
Federal Emergency Management Agency The FEMA Administrator should communicate to Regional Administrators and Regional Disability Integration Specialists a written plan for implementing its new disability integration staffing approach, consistent with the objectives established for disability integration. Such a plan should include an implementation timeline and details on staff responsibilities, which regions could use to evaluate staff performance. (Recommendation 5)
DHS agreed with this recommendation, reporting that it is developing a project plan to implement the proposed staffing approach in the Regions. The plan will include implementation timelines, detailed roles and responsibilities for the proposed Disability Integration Advisor positions, a force structure for each Region, and recommendations to the Regional Administrator to establish performance metrics for the new positions that support the overall approach to disability integration. The plan will be presented to the Administrator for review and concurrence in 2019.
Federal Emergency Management Agency The FEMA Administrator should develop a plan for delivering training to FEMA staff that promotes competency in disability awareness. The plan should include milestones and performance measures, and outline how performance will be monitored. (Recommendation 6)
FEMA agreed with this recommendation and has plans to improve disability competencies among FEMA staff, but it does not include training. Specifically, FEMA is developing a plan to include a disability integration competency in the position task books for all deployable staff, rather than through training. Position task books outline the required activities, tasks, and behaviors for each job, and serve as a record for task completion. The plan will also include a communications and outreach plan; milestones for measuring the effectiveness of the integration of this competency across the agency; and a monitoring plan and milestones to measure the overall integration of this competency across the deployable workforce. However, the plan doesn't cover how it will deliver training to promote competency in disability awareness among its staff, including milestones, performance measures, and how performance will be monitored.
Federal Emergency Management Agency The FEMA Administrator should develop a timeline for completing the development of new disability-related training the agency can offer to its partners that incorporates the needs of individuals with disabilities into disaster preparedness, response, and recovery operations. (Recommendation 7)
Closed - Implemented
DHS agreed with this recommendation. The agency reported that it developed a set of courses of action to update "Integrating Access and Functional Needs into Emergency Planning." In June 2019 FEMA issued a Request for Quote to three vendor contractors for redesigning the training course "Integrating People with Disabilities into Emergency Planning (E/L 0197)." Officials from the Office of Disability Integration and Coordination (ODIC) worked with officials from FEMA's training division to complete a Uniform Training Needs Assessment (UTNA), and developed a Statement of Work that details requirements consistent with the findings of the UTNA. ODIC officials estimate that the period of work will be approximately one year, and expect to field the course starting in August 2020.

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