Preparing Vulnerable People Project & Person Centred Risk Assessment

This session was part of the Disability and Disaster Resilience Forum held online on 27 August 2020.


Overview

The Person-Centred Emergency Preparedness framework is being used to inform the ‘Preparing Vulnerable People’ project at the CFA. The resources that have been developed as part of the project recognise that people with disability are in the best position to plan for their own safety in the event of a bushfire, because they know what they are able to do for themselves and what assistance is needed before, during and after an emergency.

Angela Cook, Project Manager, Community Engagement from the Country Fire Authority shares details of the project, the current resources available and the plans for trialing the approach over the coming bushfire season.

 

Links to resources mentioned in this session can be found at the bottom of this post.

 

Transcript & Audio

 

MELISSA HALE:
Hi everyone, here we are back again for the last presentation before lunch.  What are some of the things that are happening in the CFA?  The person centred emergency preparedness framework is being used to inform to preparing vulnerable people project at the CFA.

The resources that have been developed as part of the project recognise people with disability are in the best position to plan for their own safety in the event of a bushfire because they know what they are able to do for themselves and what assistance is needed before, during and after an emergency.

Angela Cook will share the details of the project, the current resources available and the plan for trial and the approach over the coming bushfire season.  Angela will introduce a person with lived experience who will join for the presentation so make sure you keep those questions coming in the Q&A section of Zoom.  Please welcome Angela Cook.

ANGELA COOK:
Hi everyone, first up I would like to acknowledge the traditional owners of the land, the Tomerong people where I live and pay my respect to elders past present and future and also pay my respect to Aboriginal science, culture and land management practice of which we still have so much to learn from.

It’s great to be here today as part of the forum sharing with you a project CFA is working on.  We’re working on that with other organisations and agencies as well.  Of course it’s been great to hear from Michelle about the importance of a person centred approach and an inclusive approach.

I’ve been working at CFA headquarters in community engagement for the past 14 years.  When I was younger I wanted to be a human rights lawyer at Amnesty International but the reality of studying law did not suit my strengths or patience.  Really when it came down to it I wanted to help people and help people to help themselves.

CFA suits my values and desire to work with community in a positive way to build community resilience and individual resilience and to improve safety.  I’m currently the Project Manager for the preparing vulnerable people project.  Today I thought I would share with you a story.  This story forms the foundations of the house I suppose you could call it the house we’re building with this current project.

At the time back in 2018 I was working as the senior engagement advisor for CFA in charge of program inclusiveness.  The CFA Chief Officer asked me for some assistance with a response to a letter he received, the letter received almost two years ago in December 2018.

It was from Toni.  Toni explained in the letter her circumstances.  She has MS multiple sclerosis and needs assistance to move about.  She described it to me in a later conversation as having a broken body or being broken.  In the letter she described her concerns about bushfire and wanted advice on preparation as she felt she could not leave.

I contacted Toni to understand more about her situation.  The conversation with Toni over the phone got the coggs turning in my head.  How can we at CFA help people like Toni and what does Toni need so she can help herself?  At the time I was on a working group with DHHS reviewing the vulnerable persons in emergency policy.  I had coordinated a submission from CFA about the policy as part of the review process.

We were concerned at CFA about the register and what seemed to be a focus for evacuation for people on the register.  We are concerned as vast running grass fires and bushfires don’t usually allow for evacuations.  This extended to other concerns about what if there were many people to evacuate, what if these people need specialised equipment or to be moved, to be transported, how is that going to work?  Where was the focus on preparedness planning before an emergency and in my case before a bushfire emergency?

I understand we’re not alone in harbouring these concerns individuals, agencies and organisations have similar concerns.  At the same time I also thought about and still think about CFAs message to leave early.  Here’s our advice, on the left is actually very small to see that’s a screenshot from one of our publications, which is titled Your Guide to Survival, one of our key bushfire safety publications.

I’ve highlighted a little red box.  Basically CFA advises that the safest option is to leave early on a code red extreme and severe day.  We also state if you care for children, are older or have a disability you must leave early.  Sounds simple enough.

What if you can’t leave, what if you need a lot of support and equipment to leave, what if you can’t access transport to leave?  What if leaving your house on an extremely hot day could cause more of a risk to your health due to the heat?  And what if all of this is really scary and frightening for you?

I spoke to Toni again and CFA organised a free property assessment in November 2018, this was to provide advice about reducing the risk of a bushfire impacting on the house and provide ideas for improving preparations.  I think I recall things like moving the hay bales away from the house and removing shrubs close to windows.  This is a free service that CFA provides and it becomes even more important if the resident feels they may be unable to leave or there are many challenges and barriers to overcome to enable them to leave their home.

If they’re going to be there over summer then they need to have a well-prepared property.  I felt yes CFA could assist with bushfire safety advice and help residents who have a disability, chronic medical condition or are older.  But I also felt like we could do a lot more.  I had some thinking and researching to do.

To start with Toni and I co-wrote a case study about her story.  This was completed after consultation with a local MS group that Toni is involved with and us at CFA.  We can circulate this afterwards.  What the case study did is put a voice and a person behind my concerns, it highlighted the complexities behind Toni’s situation.  She did not have at the time accessible transport.  She could not find a suitable place to relocate to even though she had tried.

For example, they tried the local shopping centre who said they did not want to take responsibility for any of Toni’s equipment.  Toni herself come up with her own plans.  Stay in the pantry hope for the best or contact a friend up the road with a horse float who could remove her, the wheelchair and a hoist.  Neither were great plans in CFAs eyes.  An ideal plan to move Toni on high-risk days takes considered planning and resources.

I’d just like to share with you the summary from the end of the case study.  People unable to respond in an emergency will be living in areas prone to disaster.  They will be in their home utilising often in home care support and we need to understand this could be a growing concern across the state.  And although carers and individuals are doing their very best to relocate on high risk days it is likely this will not be possible in all situations as highlighted by this case study.

CFA can help provide fire safety advice to improve property preparedness for bushfires to people who may be unable to leave their homes due to physical or cognitive limitations or conditions.  However, it’s still up to the property owner to put these measures in place and keep them in place.  In Toni’s case she has implemented the recommendation of CFA, which in turn alleviated some of the fear Toni feels over summer.

CFA also has especially designed program aimed at educating carers and support workers about bushfire safety and I’ll talk about that in a minute.  Although this is up to individuals and care agencies to adapt, to adopt and is not compulsory training for NDIS organisations and so forth, advocating for greater uptake of this program and a greater focus on emergency planning is something CFA should strongly support.

That’s how we ended the case study.  Then in August 2019 I wrote a paper for the CFA Executive Manager at Community Safety outlining my concerns for people at greatest risk and my suggestions for some solutions.  I paired it with this case study and what do you think happened?  Apart from having a desk that looks a bit like this desk in the picture, it’s much better now actually but it was piled up with research, reports and policy review documents.  Apart from a messy desk what actually happened?

Well the papers recommendations were accepted as a priority to CFA Community Safety and funding was sought to turn the papers recommendations into a reality.  In September 2019 I got the green light to go ahead and write a project plan for a three year funded project finishing in June 2022.  Preparing Vulnerable People or PVP Project, was born.  The project has two overarching objectives.

The first one, you can see on your screen here to build the capability of the health sector or part of the health sector and community and social services sector to support their clients at greatest risk with bushfire planning and then the second objective to target delivery of CFA, fire prevention and preparedness services for people at greater risk alongside local service providers and local government.

The good news is, really good news is we’re not doing this alone.  We’ve put together a statewide stakeholder reference group to help guide and advise the project.  It is super helpful as it brings together the emergency management sector, what I call the EM Sector and some of the community and social services sector to have some really important conversations.

You can see here up on the slide all the logos of the organisations involved like Red Cross, VCOSS, National Disability Services, NDIA and Disability Resource Centre as an advocacy group.  Then I also have an internal CFA working group, the worker bees behind the scenes doing all the work in the background.

The building capability arm of the project focuses on CFAs fire ready for community service providers program.  It’s a bit of a mouthful.  That’s the title of the program.  This program recognises that community and social service organisations are often in the best position to have conversations with their client or in the case of NDIS and managing a package yourself, to their employer about bushfire risk.   CFA just wants to help people in the sector with the information and skills they will need.

The revised program will be launched in two weeks’ time on the 11th of September.  The program consists of two sessions or modules, one focuses on the safety of the worker, and the other on the safety of their client or patient.

Each session runs for 45 minutes either through accessing an E Learning module or a CFA face-to-face session, which would in normal circumstances, be delivered face to face but at the moment we can do that online as well.  CFA has actually been delivering this program for over 10 years however the PVP Project, this current preparing vulnerable people project has allowed a much-needed facelift.

The new E Learning module gives organisations and workers more flexibility to complete it individually and a time that works for them.  The development and testing of it involved a whole host of end users.

Importantly the revised program uses a person centred emergency preparedness or PCEP framework and recognises people’s levels of preparedness can differ and this can affect how they understand and how they plan for bushfire.  The new E Learning module and resources aims to put conversations at the heart of bushfire planning.

Here on the screen you can see some of the new resources.  Both the title screen for our new E Learning module – Bushfire Planning and How to Support your Clients.  We’ve also invested in a new guide for community workers to support all the learning from the online module.  The guide has a section about the importance of person centred conversations and we worked with Michelle Villeneuve on this, thanks Michelle.

There is also a new bushfire planning template for individuals.  It has been converted in a large print version thanks to Vision Australia and it will also be available on the CFA website from the 11th of September with the other resources.  Here you can see Question 5 in the template asking about how you will get to your destination when you leave.  Toni’s circumstances has taught me that organising transport for someone can be challenging for someone who needs a special vehicle or who has specialised equipment to move.

I understand now a car is not something funded through NDIS unless this has changed lately.  This is an area that needs some preplanning and perhaps a local solution and one that is not cost prohibitive for the individual.  Of course there is a question of well where are you actually going to go and finding accommodation that is suitable.  This needs to be thought through and planned for.

We’re going to look at a short film next that hopefully highlights some of this to you.  This short film captures some of the issues encountered last summer by Delvin a resident from Lakes Entrance who was looking for somewhere to go and it takes two minutes.

VIDEO

DELVIN: 
“I live alone and I’m disabled.  When my nephew said that it was a good idea to go to the evacuation centre I just hopped on the scooter and drove down there.  They were unable to accommodate me because I can’t walk.  They had mattresses on the floors.  I obviously couldn’t get down to that or if someone helped me down I couldn’t get up.”

“So I came across Del, she was right here she was unloaded from a maxi taxi in her electric wheelchair and was just sitting there in her chair and not knowing what to do and where to go.  There were no motel rooms there was nothing available so I thought I would just try a bit further afield and rang an information line in Sale and got onto a Freemasons Home in Sale.  The woman there said she had a bed.”

ANDREA COOK:
So these experiences like Delvin’s and Toni’s they really help us at CFA to understand the planning requirements for people with a disability.  This short film has actually been created for the new E Learning module to give a lived experience perspective because it is so important to understand.

I’m going to move on now to the next objective of the project which I mentioned earlier, which is the targeted service delivery directly from CFA or what this title of this presentation is, Person Centred Risk Assessment.

This will centre around a property visit and direct engagement that is a CFA person if you would like will come to your house.  When I researched nationally what was best practice in assisting people with a disability to plan for emergencies, the PCEP framework kept coming up.  The more I read the more I liked it.   We’ve already just heard about why that is from Michelle today.

At CFA we already have trained facilitators that work in community engagement but will do some specific training to make sure they have the skills needed to have a person centred conversation or conversations.  The conversations they will have will focus on the capability wheel that Michelle introduced earlier.  As you can see it’s on this slide again.  It’s taken from the PCEP framework.  It will guide the conversation to focus on fire safety both bushfire and house fire.

CFA already delivers a property advice service.  Delivered to over 55,000 people since 2014, those good at maths can work out an average per year.  This program has recently had a full evaluation.  The evaluation highlighted that the program is largely successful.  We recently evaluated this program and the evaluation highlighted that the program is largely successful.  Individual property visits are well received and are resulting in the majority of people taking action.

Now, we want to combine the best parts of this program with our new program.  The existing program will then be mixed with more of an equal conversation style or a person centred approach where the resident is recognised as an expert in their own lives.  We will purposely target people on the vulnerable persons register and also people at greatest risk who are not on the register.  Of course people can also self-refer themselves to the services once it’s available.

The reason we want to ensure the people on the register have access to this program is because well the simple reason is they are listed there for a reason and we know evacuation is not always going to work in a response phase.

In fact Toni once said to me something that will likely stick with me for a very long time.  She said the reason for the vulnerable persons register is so police know where to find my body afterwards.

This was one of those moments, you know the ones that stop you in your tracks and it made me think what role can I play to make sure this is not what people think or what actually happens.  We really need to focus on preparedness planning with this program.  Given people will be at different stages of preparedness we plan on doing a follow up visit or phone call or perhaps a few.  We will need to have a number of conversations.

We’ve had a great offer from Red Cross to assist with this program.  Understandably the house is busy at the moment with COVID.  We will just be flexible to allow co-delivery if possible or sharing some follow up with CFA or Red Cross.

Now we’re just waiting for COVID-19 to settle down so we can begin the trial of this approach in a few municipalities.  The aim is to trial monitor and evaluate this approach this financial year so before the end of June. The trials will highlight what is needed for this to work on a larger scale.

There will be a more complex program to coordinate and delivery than our current property advice visit program.  CFA will need to work in locally with the municipality and local service providers.  What it brings to this approach is we are community based already, we already sit on local council emergency planning committees and we can be flexible to tailor the approach to meet local needs and individuals.

Once again I think it’s important to mention this project has a statewide reference group.  We’re not going it alone.  But do we have everybody that we need in the group, probably not.  But it’s a pretty good start and we’ve added and grown over the past nine months and it’s really helped me understand this sector and understand what is needed.  I also have a CFA working group that has CFA members with lived experience of a disability and a super project officer with industry experience.

Understanding what people need who have lived experience of a disability is critical to the success of this project, this experience is super important to this project and to me.  We want to be able to enact some positive change and focus on solutions.  We need to understand how we can improve preparedness planning for people with a disability.

Toni reminded me last week to recognise that we could wake up one day and our world could totally change with an unexpected diagnosis.  This is what was Toni’s experience.  Going from a functional happy existence as a psychologist advising government to appearing in Supreme Court to a MS person and then a widow with MS who is often not even listened to.  Her story and experience are a constant reminder and motivator for this project and for that I am very grateful.

Because we are lucky enough to have Toni taking part today I’m going to ask her a few questions before we move on to other questions.  Okay Toni, we’ll just start again for that first question.

How would you describe the barriers to your bushfire safety plan?

TONI
There are quite a few barriers that you would never think of.  To start with I would have to deal with the NDIS system which is quite complex and I’m not sure how it would work in a bushfire situation.  That’s a major barrier.

Then there’s the barrier of having transport so once we know the bushfire is looming what am I going to do to get out of here then where will I go.  Finding appropriate short-term accommodation is tough, it’s not like just jumping in the car and going to any accommodation.  The accommodation needs to be accessible so not only do you need to get your wheelchair in there but I need all of the equipment that would enable me to be somewhere else, which brings me to the next idea of relief centres.

They are quite overwhelming so for somebody like me where there is so much noise and hustle and bustle it can be quite frightening.  Also I need to take a support worker with me which is tough during the bushfire season because all of my support workers are living in the same environment so if the fire is looming who’s to say that support workers will want to come with me so that’s a real barrier.  Then on top of all of those what on earth is going to happen with COVID-19.

I think that provides a good list of the barriers.

ANGELA COOK:
That does provide a good list.  This is the first time we’ve bought COVID into that, COVID into bushfire as well.  That’s a double whammy if our advice is to leave and go somewhere else but going somewhere else could be unsafe because of COVID.  That’s just an extra extra layer.

For you Toni, how would you describe your current bushfire plan?

TONI:
Well leaving early as the advice often is, is very difficult to do.  Realistically I need to stay in my own home.  It’s set up for me. I’ve got all of my equipment here.  I don’t need to worry about transporting everything, to somewhere else, which is a big stressor.

Also, heat is a major issue for me and many people with MS might agree that as soon as you introduce heat into it you really need to stay somewhere cool.  That led me to thinking well how on earth would I stay here if fire is looming.

One of the first things that happens is you might lose your power so then I purchased a generator.  The generator would allow me to stay here because I could charge up all of my equipment so hoists, wheelchairs, everything.  Yeah, really it’s all kind of just identifying what is it that you can control and working very hard to make sure that your support is around you, your equipment is around you and it will be working.  That would sum up my bushfire plan at the moment.

ANGELA COOK:
Thank you Toni.  Really helps to understand what support you need to stay safe in a bushfire, what other people need in similar situations.

I remember having a conversation with our former Chief Officer from CFA saying to me you just need to get these people out they just need to leave and saying it’s more complex than that, it’s hard, it’s not as simple.  I doubt CFAs message won’t change, it will likely to remain the same the safest option is to leave early.

I suppose what can we do to help people prepare more, to think about things like generators like you have so that you have the power you will need for your assistance equipment and things like that.  And to understand I suppose what you can do which is what you shared with us.

Thanks so much, will there be any other questions because I’m aware we’re running over time?

MELISSA HALE:
Can I just say I commend your bravery Toni for coming here today and sharing the story.  I understand you have relived your trauma and there is nothing more painful than that.  We all need to collectively do better.  We really really do for people like you people like me everyone else who has a disability as well.  Thank you for sharing your story.

Angela, thank you for your presentation too.

Unfortunately we’ve run out of time but as I said at the start of the whole forum we are going to be compiling a issues paper because we don’t want the conversation to stop here.  We want to make sure that action comes from this.  We will come back to you later on when we do our issues paper with the questions from the audience as well so it doesn’t stop here.

Thank you both very much.

ANGELA COOK:
Thank you and a special thanks to Toni.

TONI
Thank you.

MELISSA HALE:
Okay everybody.  Now we will go to a lunch break.  Please enjoy the danger zone playlist compiled by DARU DJ, crank it up loud and dance like no one is watching.  Have fun and see you back and 1 o’clock.

DARU
Thursday 27th August, 2020

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