Healthcare

Legislation Protecting Children in Disasters

by Andrew Roszak

Emergencies and disasters can have a profound impact on children. However, in 2004-2012, less than $0.01 of every $10 invested by federal emergency preparedness grants went to activities geared toward improving children’s safety. As the federal government plays a major role in funding and directing emergency preparedness, it is encouraging to see recent legislative and policy developments designed to increase planning and preparation for children of all ages.

Andrew Roszak headshotThe reauthorization of the Child Care and Development Block Grant (CCDBG) Act in November 2014 was the single biggest piece of legislation affecting child care in recent memory. CCDBG is administered to states in formula block grants, which are used to subsidize child care for low-income working families (around 1.5 million children per month) and to support activities that improve the overall quality of child care for all children.

As a result of the CCDBG Act, the Administration for Children and Families (ACF) updated regulations for the Child Care and Development Fund (CCDF) for the first time since 1998. The new law and regulations represent a major shift in the primary federal grant program that provides child care assistance for families and funds child care quality initiatives. New requirements, including: background checks, health and safety standards, emergency preparedness planning, increased consumer education, and new quality initiatives are a small portion of the changes.

Reauthorizing CCDBG was a feat nearly 20 years in the making. As such, the CCDF must remain fully funded so these much needed improvements can be completely implemented. Child Care Aware® of America recommends Congress approve $4.2 billion toward these efforts for next year.

While many states and providers are working to fully implement CCDBG, Congress and the Administration have been busy with other initiatives aimed at increasing preparedness efforts for children. The partnership among the State and High-Risk Urban Area Working Group Act, Homeland Security for Children Act, and the Hospital Preparedness Program and EMS for Children seeks to ensure children are included in federally funded efforts. A detailed description of these initiatives is below.

Legislation Protecting Children in Disasters
Source: FEMA/George Armstrong, 13 May 2011, Phil Campbell, AL

H.R. 4509 – The State and High-Risk Urban Area Working Group Act

Status: Became law on 23 December 2016

Background: Passed the House of Representatives on 13 April 2016. The bill then headed to the Senate and the Committee on Homeland Security and Governmental Affairs. The bill was ultimately incorporated into S.2943 – National Defense Authorization Act for fiscal year 2017, which passed both the House and Senate and was signed into law by President Barack Obama on 23 December 2016. The law amended the Homeland Security Act of 2002 to include a new requirement for jurisdictions receiving federal funds under the state Homeland Security Grant Program (HSGP) or the Urban Areas Security Initiative (UASI).

How this helps children: The new requirements modify the membership of the planning committees. Under the new requirements, the planning committee must now include a member who represents educational institutions, including elementary schools, community colleges, and other institutions of higher education. Although there is not a specific requirement to include the child care community, jurisdictions should recognize the value of including diverse stakeholders, especially those stakeholders that represent vulnerable populations. Hopefully, including elementary schools will further open the dialogue about the need to include children in disaster planning.

For more information: Read the entire bill (the changes to the Homeland Security Act referenced above are on page 684).

H.R. 1372 – Homeland Security for Children Act

Status: Introduced in House on 6 March 2017

Background: This bipartisan bill would amend the Homeland Security Act of 2002 to better integrate children into the Department of Homeland Security’s policies, programs, and initiatives. This includes work performed throughout the Department of Homeland Security, including the Federal Emergency Management Agency (FEMA).

  • First, the bill modifies the responsibilities of the under secretary for strategy, policy, and plans (known as the DHS Office of Policy), to include a new charge to lead, conduct, and coordinate identification and integration of the needs of children into the Department of Homeland Security’s policies, programs, and activities. It also allows for this work to be performed in coordination with relevant outside organizations and experts, as necessary.
  • Second, the bill directs the administrator of FEMA to “identify and integrate the needs of children into activities to prepare for, protect against, respond to, recover from, and mitigate against the risk of natural disasters, acts of terrorism, and other manmade disasters, including catastrophic incidents.” It also includes authorizing language for FEMA to appoint a technical expert, “who may consult with relevant outside organizations and experts, as necessary, to coordinate such integration, as necessary.’’
  • Third, the bill mandates the creation of an annual report, each year for five years, that describes the efforts the Homeland Security Department has taken to identify and integrate the needs of children into policies, programs, and activities.

How this helps children: The introduction of this bill and the holistic approach it takes to ensures the needs of children are met not only at FEMA, but also within the entire Department of Homeland Security. As the federal agency charged with ensuring the safety of the homeland, the Department of Homeland Security has a wide-ranging mission. Per statute, the under secretary for strategy, policy, and plans, is the principal policy advisor to the secretary, and is appointed by the president, by and with the advice and consent of the Senate.

Expanding the under secretary’s responsibilities ensures that children will be considered in all of the department’s activities. As the federal entity charged with counterterrorism, border security, enforcement of immigration laws, safety and security of cyberspace, as well as response and recovery to disasters, ensuring that the needs of children are considered is of paramount importance. This bill correctly recognizes that children interface with the Department of Homeland Security in far more situations than just disasters. This is an important reminder of the ramifications that the surge of unaccompanied minors that were apprehended in 2014 and again in 2016.

For more information: Read and track the progress of this bill.

Hospital Preparedness Program and EMS for Children Program

Status: Ongoing programs

Background: The Hospital Preparedness Program is administered by the U.S. Department of Health and Human Services’ Assistant Secretary for Preparedness and Response. The program provides funding to states, territories, and eligible municipalities to improve surge capacity and enhance community and hospital preparedness for public health emergencies. In recent years, this funding has been used to encourage the establishment and maintenance of health care coalitions. Funding for the Hospital Preparedness Program has declined over the past several years – the funding level for fiscal year 2016 was $228 million, down from nearly $500 million in fiscal year 2005.

The Emergency Medical Services (EMS) for Children Program is administered by the U.S. Department of Health and Human Services’ Health Resources and Services Administration. EMS for Children was established in 1984 and provides state governments and institutions of higher learning with funding to support improvements in pediatric emergency medical care. EMS for Children was funded at $20.162 million in fiscal year 2016. Although the Hospital Preparedness Program and the EMS for Children Program are run out of two different agencies, there is a lot of synergy between these two programs.

How this helps children: Both of these programs, on their own, perform great work and help to bolster emergency medical systems and services. The good news is that the Hospital Preparedness Program requires a joint letter of support between EMS for Children awardees and Hospital Preparedness Program awardees. Requiring this level of cooperation is a big win for children, especially in jurisdictions where the two funding streams are housed within separate entities. This coordination ensures that hospitals are better prepared for pediatric patients and that the voice of children is included in planning efforts. The health care coalitions created by the Hospital Preparedness Program are an excellent forum for examining the needs of children in everyday emergencies and in mass casualty events. Already convened and comprised of experts, these coalitions could make substantial changes within their communities to better prepare for the needs of children. To fully maximize efforts on pediatric readiness, response, and recovery, coalitions should consider including a child care provider or child care resource and referral staff member to the coalition.

For more information: Visit the websites of the Hospital Preparedness Program and the EMS for Children Program.

Undeniably, emergencies and disasters have a major impact on children and families. A systemic and deliberate approach is needed by emergency managers, first responders, and public health officials to ensure the needs of children, including infants and toddlers, are being acknowledged, planned for, and met during disasters. The federal government should ensure funding for emergency preparedness, response, and recovery efforts that benefit all citizens, including children. Even in a partisan environment, one issue bridges the gap: there is a need to protect children during emergencies and disasters.

DomPrep is conducting a podcast, moderated by Andrew Roszak, which will be available on 26 April 2016.

Andrew Roszak, JD, MPA, EMT-P, serves as the senior director for emergency preparedness at Child Care Aware® of America. He is a recognized expert in emergency preparedness, public health, and environmental health. His professional service includes work as the senior preparedness director of environmental health, pandemic preparedness, and catastrophic response at the National Association of County and City Health Officials; at the MESH Coalition and the Health and Hospital Corporation of Marion County, Indiana, as the senior preparedness advisor supporting Super Bowl 46 and the Indianapolis 500; as a senior advisor for the U.S. Department of Health and Human Services; on the Budget and HELP Committees of the United States Senate; and at the Illinois Department of Public Health. Before becoming an attorney, he spent eight years as a firefighter, paramedic, and hazardous materials technician in the Chicago-land area. He has an AS in Paramedic Supervision, a BS in Fire Science Management, a Master of Public Administration, and a Juris Doctorate degree. He is admitted to the Illinois and District of Columbia Bars and is admitted to the Bar of the U.S. Supreme Court. Twitter: @AndyRoszak