1. Disaster Management and Recovery
- Recommendation 1.1: Distinguish and comprehensively integrate the needs of children across all inter- and intra-governmental disaster management activities and operations.
- Recommendation 1.2: The President should accelerate the development and implementation of the National Disaster Recovery Framework with an explicit emphasis on addressing the immediate and long-term physical and mental health, educational, housing, and human services recovery needs of children.
- Recommendation 1.3: The Department of Homeland Security (DHS)/Federal Emergency Management Agency (FEMA) should ensure that information required for timely and effective delivery of recovery services to children and families is collected and shared with appropriate entities.
- Recommendation 1.4: DHS/FEMA should establish interagency agreements to provide disaster preparedness funding, technical assistance, training, and other resources to state and local child serving systems and child congregate care facilities.
2. Mental Health
- Recommendation 2.1: The Department of Health and Human Services (HHS) should lead efforts to integrate mental and behavioral health for children into public health, medical, and other relevant disaster management activities.
- Recommendation 2.2: HHS should enhance the research agenda for children’s disaster mental and behavioral health, including psychological first aid, cognitive-behavioral interventions, social support interventions, bereavement counseling and support, and programs intended to enhance children’s resilience in the aftermath of a disaster.
- Recommendation 2.3: Federal agencies and nonfederal partners should enhance pre-disaster preparedness and just-in-time training in pediatric disaster mental and behavioral health, including psychological first aid, bereavement support, and brief supportive interventions, for mental health professionals and individuals, such as teachers, who work with children.
- Recommendation 2.4: DHS/FEMA and the Substance Abuse and Mental Health Services Administration (SAMHSA) should strengthen the Crisis Counseling Assistance and Training Program (CCP) to better meet the mental health needs of children and families.
- Recommendation 2.5: Congress should establish a single, flexible grant funding mechanism to specifically support the delivery of mental health treatment services that address the full spectrum of behavioral health needs of children, including treatment of disaster-related adjustment difficulties, psychiatric disorders, and substance abuse.
3. Child Physical Health and Trauma
- Recommendation 3.1: Congress, HHS, and DHS/FEMA should ensure availability of and access to pediatric medical countermeasures (MCMs) at the federal, state, and local levels for chemical, biological, radiological, nuclear, and explosive threats.
- Recommendation 3.2: HHS and the Department of Defense (DoD) should enhance the pediatric capabilities of their disaster medical response teams through the integration of pediatric-specific training, guidance, exercises, supplies, and personnel.
- Recommendation 3.3: HHS should ensure that health professionals who may treat children during a disaster have adequate pediatric disaster clinical training.
- Recommendation 3.4: The Executive Branch and Congress should provide resources for a formal regionalized pediatric
system of care to support pediatric surge capacity during and after disasters.
- Recommendation 3.5: Prioritize the recovery of pediatric health and mental health care delivery systems in disaster-affected areas.
- Recommendation 3.6: The Environmental Protection Agency (EPA) should engage state and local health officials and nongovernmental experts to develop and promote national guidance and best practices on re-occupancy of homes, schools, child care, and other child congregate care facilities in disaster-impacted areas.
4. Emergency Medical Services and Pediatric Transport
- Recommendation 4.1: The President and Congress should clearly designate and appropriately resource a lead federal agency for emergency medical services (EMS) with primary responsibility for the coordination of grant programs, research, policy, and standards development and implementation.
- Recommendation 4.2: Improve the capability of EMS to transport pediatric patients and provide comprehensive prehospital pediatric care during daily operations and disasters.
- Recommendation 4.3: HHS should develop a national strategy to improve federal pediatric emergency transport and patient care capabilities for disasters.
5. Disaster Case Management
- Recommendation 5.1: Disaster case management programs should be appropriately resourced and should provide consistent holistic services that achieve tangible, positive outcomes for children and families affected by the disaster.
6. Child Care and Early Education
- Recommendation 6.1: Congress and HHS should improve disaster preparedness capabilities for child care.
- Recommendation 6.2: Congress and federal agencies should improve capacity to provide child care services in the immediate aftermath of and recovery from a disaster.
- Recommendation 6.3: HHS should require disaster preparedness capabilities for Head Start Centers and basic disaster mental health training for staff.
7. Elementary and Secondary Education
- Recommendation 7.1: Congress and federal agencies should improve the preparedness of schools and school districts by providing additional support to states.
- Recommendation 7.2: Congress and the Department of Education should enhance the ability of school personnel to support children who are traumatized, grieving, or otherwise recovering from a disaster.
- Recommendation 7.3: Ensure that school systems recovering from disasters are provided immediate resources to reopen and restore the learning environment in a timely manner and provide support for displaced students and their host schools.
8. Child Welfare and Juvenile Justice
- Recommendation 8.1: Ensure that state and local child welfare agencies adequately prepare for disasters.
- Recommendation 8.2: Ensure that state and local juvenile justice agencies and all residential treatment, correctional, and detention facilities that house children adequately prepare for disasters.
- Recommendation 8.3: HHS and the Department of Justice (DOJ) should ensure that juvenile, dependency, and other courts hearing matters involving children adequately prepare for disasters.
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.
- Recommendation 10.1: Prioritize the needs of families with children, especially families with children who have disabilities or chronic health, mental health, or educational needs, within disaster housing assistance programs.
- Recommendation 11.1: Congress and federal agencies should provide sufficient funding to develop and deploy a national information sharing capability to quickly and effectively reunite displaced children with their families, guardians, and caregivers when separated by a disaster.
- Recommendation 11.2: Disaster plans at all levels of government must specifically address the evacuation and transportation needs of children with disabilities and chronic health needs, in coordination with child congregate care facilities such as schools, child care, and health care facilities.
SOURCE: National Commission on Children and Disasters. 2010. Report to the President and Congress. AHRQ Publication No. 10-M037, October 2010. Rockville, MD: Agency for Healthcare Research and Quality. http://www.ahrq.gov/prep/nccdreport (accessed September 8, 2013).