Screen Reader Mode Icon

2019 Emergency Prepardeness Needs Assessment for Disabled Households

The following survey will assess the emergency preparedness activities and needs of persons with disabilities and their families to determine the capacity of each family to prepare for and shelter or evacuate safely during national, state, or local emergency events.

The survey will examine readiness to respond to an emergency or changes needed for emergency shelters to improve the inclusivity of shelter and emergency management activities to serve persons with disabilities and their families.

This survey is designed and distributed by the Florida Department of Health's (FDOH) Disability and Health Program in conjunction with the FDOH School Health Coordinators,  University of Florida's  Office on Disability and Health and Center for Autism and Related Disabilities, Florida State University Centers for Autism and Related Disabilities,  and the Florida Association of Centers for Independent Living.

Please complete the survey to the best of your ability. Your answers will be kept confidential and you will not be penalized by any agency or participating partners in terms of services or assistance.

If you have any questions, please contact:

Bryan Russell: Bryan.Russell@flhealth.gov, DHP Program Manager 

Patrick Hodge: Patrick.Hodge@flhealth.gov, DHP Program Evaluator

Question Title

* 1. How many people are currently living in your household, including children
and the elderly?

Question Title

* 2. How many children under the age of 18 years are currently living in
your household?

Question Title

* 3. How many individuals above the age of 64 years are currently living in
your household?

Question Title

* 4. Does anyone in your household need assistance with day to day activities at home or outside the house?

Question Title

* 5. Does anyone in your household have a service animal?

Question Title

* 6. Does anyone currently living in your household use assistive devices,
such as a wheelchair, cane, glasses, etc.?

Question Title

* 7. Does anyone currently living in your household require regular clinical
services on a daily or structured basis, such as counseling, medical care,
behavioral modification, etc.?

Question Title

* 8. Does anyone currently living in your household require assistance with
visual or oral comprehension of public communications? 
(Public communications include, but are not limited to: emergency weather sirens, emergency weather TV bulletins, emergency broadcast warnings,
etc.)

Question Title

* 9. Does your household have a plan in case of a weather emergency or disaster situation?

Question Title

* 10. Does your household have any family or friends near your home you could rely upon  for assistance if an emergency occurs?

Question Title

* 11. A standard emergency preparedness kit contains items to last you and your household for at least 72 hours. (Of these items, which ones do you currently have? )
(please check all that may apply)

Question Title

* 12. Do you know the location of your area’s emergency shelters?

Question Title

* 13. Do you understand the public warning messages used by emergency management agencies?

Question Title

* 14. Do you or any member of you household have any developmental and/or
intellectual impairments that would make it difficult to understand
proper evacuation procedures during an emergency?

Question Title

* 15. Do you or any members of your household have mobility limitations which would interfere with evacuating or accessing emergency shelters?

Question Title

* 16. Do you or any member of your household have any developmental,
emotional, or psychological impairment(s) that would make it
difficult to comply with shelter rules or instructions?

Question Title

* 17. What barriers do you and your household face in preparing for an emergency or disaster?  (Select all that apply)

*A barrier is a circumstance or obstacle that prevents a person from
accomplishing a task or making progress on a project.
Common barriers to preparing for an emergency or disaster include:
financial ability to purchase needed materials and additional medications;
accessible transportation to a shelter and accessibility of the shelter.

Question Title

* 18. What barriers, if any, would you and your household face in evacuating or accessing an emergency shelter?

Question Title

* 19. If you and your household decide to evacuate to a shelter during a storm or any other emergency situation, what specific accommodations would you want or need? Please be as specific as possible. (Select all that apply)

Question Title

* 20. Have you ever stayed in an emergency shelter?

Question Title

* 21. How long did you stay in the emergency shelter?

Question Title

* 22. Was the shelter adequately prepared to care for your or your family
member's medical or special needs?

Question Title

* 23. Would you expect the emergency shelter to make available specific
equipment to make the stay easier on your family member with a disability,
or would you provide your own specific equipment (i.e. noise-cancelling
headphones, sensory objects, weighted blankets, etc.)?

Question Title

* 24. How long would you expect to stay in a shelter during an expected short-term emergency?

Question Title

* 25. What services provided by emergency shelter staff would be beneficial to assist you and your family in returning home after the severe weather or disaster event?

0 of 25 answered
 

T