A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

2022 | VOLUME 17 | ISSUE 1–2

People With Functional and Access Needs and Disasters

The Dialogue
The Dialogue is not responsible for the information provided by any web pages, materials, or organizations referenced in this publication. Although 

The Dialogue includes valuable articles and collections of information, SAMHSA does not necessarily endorse any specific products or services 

provided by public or private organizations unless expressly stated. In addition, SAMHSA does not necessarily endorse the views expressed by such 

sites or organizations, nor does SAMHSA warrant the validity of any information or its fitness for any particular purpose.

The Dialogue is a quarterly technical assistance journal on disaster behavioral health which 

is produced by the Substance Abuse and Mental Health Services Administration (SAMHSA)

Disaster Technical Assistance Center (DTAC). Through the pages of The Dialogue, disaster 

behavioral health professionals share information and resources while examining the 

disaster behavioral health preparedness and response issues that are important to the field. 

The Dialogue also provides a comprehensive look at the disaster training and technical 

assistance services SAMHSA DTAC provides to prepare states, territories, tribes, and local 

entities so they can deliver an effective disaster behavioral health response. 

SAMHSA DTAC provides disaster technical assistance, training, consultation, resources, 

information exchange, and knowledge brokering to help disaster behavioral health 

professionals plan for and respond effectively to mental health and substance misuse needs 

following a disaster.

To learn more or receive The Dialogue, please call 1–800–308–3515, email dtac@samhsa.

hhs.gov, or visit the SAMHSA DTAC website at https://www.samhsa.gov/dtac.

IN THIS ISSUE

3 In This Issue

4 Contributors

7 Technical Assistance Snapshot

8 Including People With Access and Functional Needs in Disaster Preparedness, Response, 

and Recovery

11 Delivering Accessible Communications About COVID-19 to Individuals With Disabilities 

14 California’s CCP Serves People With Different Abilities

16 Disaster Response for the Whole Community: Colorado’s Work Toward Access and 

Functional Needs Integration and Community Inclusion

20 The C-MIST Framework

22 “Help Where You Are and Hope When You Need It”: Meeting the Diverse Needs of Ohio’s 

Residents in a Pandemic

25 How Service Animals Empower People With Disabilities in Disasters

28 Recent Technical Assistance Requests
2022 | VOLUME 17 | ISSUE 1–2 | PAGE 3

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

According to the Census Bureau, more than one in 

four people in the United States has a disability. That 

amounts to 85.3 million people (Taylor, 2018). The 

disability community in the United States is rich and 

varied. In addition to including people with a range of 

disability types, this community boasts the same rich 

diversity as the full U.S. population in terms of race and 

ethnicity, culture, language, age, socioeconomic status, 

gender identity, sexual orientation, and life experience. 

People with disabilities move through a world largely 

designed for people without disabilities. As noted in 

an article in this issue, they are essentially emergency 

managers every day. Many people with disabilities 

have developed strong coping skills and resilience, as 

well as supportive networks to function and thrive. In 

spite of these strengths, people with disabilities have 

sometimes had worse experiences in and after disasters 

(Chakraborty et al., 2019; Stough et al., 2016; Frieden, 

2006; Center for Disaster Philanthropy, n.d.; Mann et al., 

2021). In many cases this was because disaster planning 

and management processes missed taking them into 

account. Efforts underway since shortly after September 

11th and Hurricane Katrina have begun to remedy this 

issue. Some approaches have focused on functional and 

access needs, a framework broader than disabilities that 

may better reflect actual needs people experience during 

and after disasters. 

In this edition of The Dialogue, we consider ways 

to ensure inclusion of people with disabilities and 

other functional and access needs in all phases of 

disaster preparedness, response, and recovery. After 

an article about functional and access needs, the next 

article spotlights work done in collaboration with 

the Centers for Disease Control and Prevention to 

produce accessible materials and information about the 

COVID-19 pandemic for people with disabilities. In two 

articles, states with Crisis Counseling Assistance and 

Training Program grants that have done especially well 

in reaching people with disabilities describe approaches 

In This Issue

they used and lessons learned. Another article focuses on 

working with people with service animals in disasters. 

Also, a disaster behavioral health expert from Colorado 

describes work the state has done to ensure inclusion of 

the whole community, including people with access and 

functional needs, in disaster preparedness, response, and 

recovery. 

Have you been part of work to include people with 

disabilities and other access and functional needs in 

disaster preparedness, response, and recovery? Are 

you someone who has a disability or other functional 

or access need who has been involved in emergency 

management or disaster behavioral health? Other 

planners and responders can learn from your efforts. We 

encourage you to contact us to share your stories and 

lessons learned. ■

CAPT Erik Hierholzer, B.S.N. Program Management 

Officer, Emergency Mental Health and Traumatic Stress 

Services Branch

erik.hierholzer@samhsa.hhs.gov

Nikki Bellamy, Ph.D. Public Health Advisor, 

Emergency Mental Health and Traumatic Stress 

Services Branch

nikki.bellamy@samhsa.hhs.gov

Shannon Loomis, M.A. Director, SAMHSA Disaster 

Technical Assistance Center

dtac@samhsa.hhs.gov

Based on some measures, 

more than

 1 in 4 people 

living in the United States has a disability. 

This amounts to 85.3 million people, 

or 27.2 percent of the population.

 Source: Taylor, 2018
2022 | VOLUME 17 | ISSUE 1–2 | PAGE 4

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

Senate Office of Research, and Assembly Ways and 

Means Committee. Flores has extensive experience 

with Medicaid policy and fiscal issues, with a specific 

focus on mental health and substance use, children’s 

issues, quality measures, and federal Medicaid waivers. 

She holds a B.S. in engineering from the University of 

California, Berkeley, and a master’s in public policy 

from Harvard Kennedy School of Government.

Cg Garrard, M.A., is an 

accomplished consultant 

with 18 years of experience 

in emergency management 

who also happens to have a 

disability. She has worked 

with all levels of government: federal, state, and local,

as well as engaging local communities and privatesector partners in emergency planning and resilience

efforts. Garrard excels at building relationships with

stakeholders and engaging in productive discussion

on inclusion, equity, diversity, and anti-racism in

emergency management planning and operations. She

is the Founder and Owner of hazard-management firm

Griffin LLC. Garrard conducts business with the support

of her service dog and “Chief Barketing Officer,” Noni. 

Contact info@griffinworks.org or visit https://www.

griffinworks.org/training to learn more about Griffin’s

training, Pawsitive Interactions with Service Dogs

During Response Operations ©.

Valerie Nash, M.A., is the 

Planning and Development 

Consultant to the San Diego 

Refugee Communities 

Coalition. She delivers technical 

assistance and support to the 

Contributors

Kirsten Brownlee has served at 

the Ohio Department of Mental

Health and Addiction Services

for over a year as a Data Entry

Operator. Brownlee earned

an associate of science degree

from Columbus State Community College. Brownlee 

works with the Regular Services Program (RSP) grant 

providing technical assistance to awardees, creating data 

reports, and assisting with technical writing. Brownlee 

enjoys working with RSP awardees and hearing impact 

stories regarding the grant. She also works on the State 

Opioid Response grant providing technical support, 

restructuring data, and developing federal and state 

reports. Brownlee presents at state-level meetings. She 

is a certified dog trainer and enjoys translating and 

speaking Japanese.

Kim Flores, M.P.P., is a 

Consultant to the California 

Mental Health Services 

Authority (CalMHSA) and 

serves as the Project Manager 

of CalMHSA’s CalHOPE 

project. CalMHSA is contracted with the California 

Department of Health Care Services to implement the 

Federal Emergency Management Agency (FEMA)/

Substance Abuse and Mental Health Services 

Administration COVID-19 Crisis Counseling Assistance 

and Training Program, Student Support, and Together 

for Wellness portions of the CalHOPE project. Prior to 

this, Flores advised the California County Behavioral 

Health Directors Association on various regulatory 

compliance, Medicaid, state budget, and mental healthand substance use-related policy issues. Flores worked 

for the California legislature for 30 years, including 

the Senate Health and Human Services Committee, 
2022 | VOLUME 17 | ISSUE 1–2 | PAGE 5

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

coalition’s member organizations, working closely with 

colleagues at the University of California San Diego’s 

Refugee Health Unit. Nash has provided a range of 

consulting services to clients in California, Hawaii, 

and British Columbia, Canada, since 1998. Much of 

her work is centered on helping communities design 

effective solutions to complex social problems and 

addressing systemic inequities. She has co-authored 

numerous assessments and reports and served as 

principal investigator and consultant to projects funded 

by the Centers for Disease Control and Prevention 

(CDC), California Office of Emergency Services, and 

County of San Diego Health and Human Services 

Agency. Nash has also been part of the University of 

San Diego’s Nonprofit Institute since 2016, providing 

training in program design, development, and 

evaluation. Originally from England, Nash studied at 

Warwick and Oxford Universities before completing a 

master’s in psychology at Boston College.

Liz Persaud is a nationally 

recognized public speaker 

and advocate addressing the 

need to build bridges and 

solidify the gaps between 

individuals living with and 

without disabilities. Persaud currently serves as the 

Program and Outreach Manager for Tools for Life, 

Georgia’s Assistive Technology Act Program, at the 

Center for Inclusive Design and Innovation (CIDI) 

within the College of Design at the Georgia Institute 

of Technology (Georgia Tech). Persaud serves on the 

Board of Directors at NMD United, Inc., providing 

outreach and raising disability awareness to numerous 

groups and organizations across the globe. Her passion 

lies within education about generations of adults 

growing up and living independently and successfully 

with childhood neuromuscular diseases. Persaud is 

sought after for her storytelling ability, shedding light 

on the power of assistive technology and its impact 

on the lives of individuals living with disabilities and 

their support circles. Persaud has dedicated her life to 

increasing independence for individuals with disabilities 

by educating on self-determination and advocacy with a 

focus on technology and disabilities. She is a graduate of 

Georgia State University.

Carolyn Phillips is 

internationally recognized in the 

fields of assistive technology, 

inclusive design, accessibility, 

and disabilities. Phillips serves 

as Co-Director of CIDI at 

Georgia Tech and Director & Principal Investigator of 

Tools for Life, Georgia’s Assistive Technology (AT) 

Act Program. She is a frequent keynote speaker at 

conferences and guest lecturer at universities throughout 

the globe. Phillips serves as the Associate Editor for 

the AT Outcomes and Benefits (ATOB) journal and has 

published articles in journals, chapters in books on AT, 

and poetry focused on living with disabilities. Phillips 

received her undergraduate degree from the University 

of Georgia and her master’s degree from the University 

of Kentucky, and she is currently pursuing her Ph.D. at 

Texas Tech University.

Patricia Redmon is a Special 

Project Consultant to the 

Center for Inclusive Design and 

Innovation at Georgia Tech. She 

has developed resources for the 

reuse of assistive technology, 

prepared accessibility guidance for international 

projects, and provided administrative support for 

research. Her prior experience includes senior editorial 

and management roles at Knight-Ridder Newspapers 

and in publishing-related technology, and participation 

in the development and implementation of standards for 

document processing. She has consulted with healthcare 

organizations and leading scientific and medical 

publishers. She holds a B.S. in English education and an 

M.B.A. in marketing from Florida State University.
2022 | VOLUME 17 | ISSUE 1–2 | PAGE 6

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

Christine Sielski, M.S.W., is the 

Assistant Chief for the Bureau 

of Grants Administration 

at the Ohio Department of 

Mental Health and Addiction 

Services. Sielski is also the 

Project Director for Ohio’s Regular Services Program 

and State Opioid Response (SOR) 2.0 grants. Sielski is 

passionate about building an integrated system of care 

for individuals with substance use and co-occurring 

disorders to create a continuum of care across Ohio. 

Sielski holds a bachelor’s degree in psychology and a 

master’s degree in social work from Ohio UniversityAthens and is currently completing a Ph.D. in social 

work at the Ohio State University. Sielski has taught 

courses at the Ohio State University and teaches primary 

care residents how to develop and complete medical 

research projects. An engaging speaker and author, 

Sielski has served as first author and second author on 

various research publications and given presentations 

at state and national conferences. Sielski spends time 

working with women experiencing breast cancer with 

the goal of helping women and their families understand 

how they experience this journey.

Charlotte Stasio excels 

at developing emergency 

management and public 

safety plans and policy. Her 

professional experience 

includes developing doctrine 

for FEMA and local policy and planning guidance for 

jurisdictions in the National Capital Region. Stasio is 

a certified emergency medical technician and works 

in the field as a first responder for an emergency 

medical services provider in Philadelphia. She serves 

as Director of Operations for Griffin LLC, a firm on a 

mission to advance access and inclusion in emergency 

management. 

Aimee Voth Siebert, M.A.,

is the Disaster Behavioral 

Health and Inclusion 

Worklead for the Colorado 

Department of Public Health 

and Environment’s Office 

of Emergency Preparedness and Response (CDPHE 

OEPR). Voth Siebert holds a master’s in international 

disaster psychology from the University of Denver. 

She enthusiastically weaves cross-cultural psychology; 

community engagement; mental health, substance 

use disorder prevention, and public health; crisis 

communication; and neuroscience into the broader 

disaster conversation, promoting a people-centered lens 

for emergency preparedness and response. In 9.5 years 

with OEPR, Voth Siebert has supported Colorado’s 

responses to the COVID-19 pandemic, the 2013 floods, 

multiple wildfire seasons, and several mass shooting 

events. In 2015, she deployed with CDC’s Ebola 

response in Sierra Leone, and in October 2017, she 

led Colorado’s Emergency Management Assistance 

Compact disaster mental health team in supporting 

Puerto Rico’s response to Hurricane Maria. Voth 

Siebert also contributes leadership to the development 

of Colorado’s Access and Functional Needs Program. 

In 2019, she co-chaired the inaugural “Getting It 

Right” Access and Functional Needs Conferences in 

Colorado, and the Community Inclusion in Colorado 

mapping project, which she leads, was recognized as 

a “promising practice” for emergency management 

inclusive of people with disabilities by FEMA and the 

Americans with Disabilities Act National Network in 

2015. ■
2022 | VOLUME 17 | ISSUE 1–2 | PAGE 7

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

TECHNICAL ASSISTANCE SNAPSHOT

Crisis Counseling Assistance and Training Program (CCP)

Encounters with People With Disabilities

2019–2021

Physical

Mental Health/

Substance Use

Intellectual/

Cognitive

2019 2020 2021

Source: CCP data as reported to the SAMHSA Disaster Technical Assistance Center

50%

40%

30%

20%

10%

0%

The CCP provides supplemental assistance to help states, U.S. territories, and federally recognized 

tribes meet mental health and substance use-related needs after a disaster. CCP data are collected for 

program development and improvement, including data on percentages of people served who have 

disabilities. From 2019 to 2021, CCPs served more people with physical disabilities than mental 

health or substance use-related disabilities or intellectual or cognitive disabilities. However, they 

reached people in all three groups.

“A crisis counselor described how she works with a lot 

of families whose children have autism, or where the 

grandparent is struggling with dementia. They have had a 

much more difficult time with COVID-19, and they have less access 

to mainstream resources and services due to language barriers. She 

talked about how isolated and afraid these families have been and 

how valuable the CCP is.”

Source: Flores & Nash

“The CCP staff began assisting 

Ohioans by meeting them where 

they were. Creative and culturally 

diverse staff brought a new level 

of sensitivity and competence in 

working with people with different 

abilities.”

Source: Sielski & Brownlee
2022 | VOLUME 17 | ISSUE 1–2 | PAGE 8

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

Wherever you live, your community 

likely includes people with access 

and functional needs, identified by 

the Federal Emergency Management 

Agency (FEMA) as “individuals 

who need assistance due to any 

condition (temporary or permanent) 

that limits their ability to take 

action” (FEMA, 2014). People with 

access and functional needs in a 

disaster may include people in a 

wide range of communities:

• People with limited proficiency 

in spoken or written English, 

who may need disaster warnings 

and other emergency information 

provided in languages they read 

and speak

• People who are deaf or hard of 

hearing who use American Sign 

Language and need information 

provided in that language

• People who are blind or people 

with low vision, who may need 

written information provided 

in braille, large-print, or audio 

formats

• People with intellectual or 

developmental disabilities, who 

may need information provided in 

simplified language

• People who use wheelchairs 

or other mobility devices, who 

may need accessible shelters 

and transportation options for 

evacuation

• People who use medications 

to manage health conditions, 

including mental health conditions 

and recovery from substance use 

disorders, as medications may 

be hard to get during and after 

disaster

• People with serious mental 

illness, who may have developed 

networks of service professionals 

and supports that may be disrupted 

by disaster

• People who do not own personal 

vehicles or have access to 

transportation for evacuation

• People in any other group who 

may need resources or support 

to take action before, during, and 

after a disaster in support of their 

health, well-being, and usual 

functioning

To ensure whole-community 

preparedness and effective disaster 

response and recovery, you will 

need to include and account for 

people with access and functional 

needs in all phases of emergency 

management and disaster response. 

Including People With Access and Functional 

Needs in Disaster Preparedness, Response, 

and Recovery

By SAMHSA Disaster Technical Assistance Center Staff
2022 | VOLUME 17 | ISSUE 1–2 | PAGE 9

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

This work can be challenging, 

especially if you and your 

organization do not have preexisting 

relationships with people with 

functional and access needs or 

organizations run by and serving 

these communities. However, like 

other changes made for people with 

access and functional needs, from 

sidewalk curb cuts for people who 

use wheelchairs to translation of 

health information into simplified 

language, these efforts stand to 

benefit your whole community and 

result in better disaster response 

and recovery for all (Disabilities, 

Opportunities, Internetworking, and 

Technology Center, University of 

Washington, 2021). 

Following are steps you can 

take to ensure that your disaster 

planning and preparedness work 

includes people with functional 

and access needs and that response 

and recovery processes involve the 

whole community.

Before a Disaster: Planning 

and Preparedness

• Invest in understanding your 

community and building networks. 

Who makes up your community? 

What needs may they have in a 

disaster? 

• Establish a working group 

on emergency planning and 

preparedness for people with 

access and functional needs, or 

several working groups for specific 

communities of people with 

access and functional needs and 

disabilities. Include representatives 

of the communities of people with 

functional and access needs in 

your area in standing emergency 

planning and preparedness 

meetings. You may be able to find 

state, territory, tribal, and local 

contacts through the Aging and 

Disability Networks section of the 

Administration for Community 

Living’s website at https://acl.gov/

programs/aging-and-disabilitynetworks. You may also want to 

reach out to your state or local 

government community mental 

health provider organizations. 

Meet regularly with various groups 

to collaborate on disaster planning 

and preparedness.

• Plan and budget for translation 

and interpretation of information 

in languages other than English 

that people in your community 

speak, particularly people with 

limited proficiency in written 

and/or spoken English. This 

may include sign language such 

as American Sign Language, 

as well as large print or braille 

for print publications. Ideally 

it also will include testing draft 

Like other changes 

made for people with 

access and functional 

needs, these efforts 

stand to benefit your 

whole community and 

result in better disaster 

response and recovery 

for all.

Disabilities, Opportunities, Internetworking, and 

Technology Center, University of Washington, 2021
2022 | VOLUME 17 | ISSUE 1–2 | PAGE 10

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

communications to make sure they 

are appropriate for and make sense 

to intended audiences. 

• Plan and budget for disaster 

warning systems that rely on 

visual as well as auditory cues. 

• Plan and budget for disaster 

communication in visual as well 

as verbal formats (i.e., handouts 

showing information in pictures 

only, or in pictures in conjunction 

with written information).

• Plan to ensure availability of 

shelters that are accessible to all 

members of your community, 

including people using 

wheelchairs, canes, or other 

mobility devices or people with 

service animals.

• Plan evacuation support for 

people without access to personal 

vehicles.

• Plan to ensure continuity of access 

to medication. 

• Plan to ensure continuity of care 

and access to support networks 

for people who use systems and 

supports to manage serious mental 

illnesses and recovery from 

substance use disorders.

• Plan to ensure continuity of 

access to health care and devices 

for people with chronic health 

conditions (e.g., supplemental 

oxygen supplies for people with 

emphysema, nebulizers for people 

with asthma). 

During a Disaster

• Present information in a range 

of formats, including in written 

words, pictures, and videos.

• Provide disaster warnings that are 

visual as well as auditory, and in 

tactile or haptic format if possible.

• Provide sign language 

interpretation of disaster 

information.

• Provide vital information 

early, and in plain language, 

for people with intellectual 

and developmental disabilities. 

Simplify instructions, breaking 

them down into smaller steps and 

providing them in written form.

After a Disaster

• Provide health information, 

including psycho-educational and 

coping materials, in languages 

members of your community 

use. This may include several 

languages other than English, 

including sign languages such as 

American Sign Language, as well 

as large-print publications and 

publications in braille.

• Provide shelters that are accessible 

to the whole community, which 

may include people who use 

wheelchairs or canes, people with 

service animals, and people with 

sensory or neurological differences 

such as autism or serious mental 

illness who may benefit from 

additional space or more private 

accommodations if available. 

For example, aisles should be 

sufficiently wide for someone 

using a wheelchair to navigate, 

and private spaces should be 

available for those who need to 

have discussions with their mental 

health or substance use support 

service providers.

• Ensure that sites where resources 

and services are provided to 

survivors are accessible to the 

whole community.

• Offer assistance, or allow for 

support from friends or loved ones, 

for people who need this support 

in completing forms and reporting 

events in the order in which they 

happened. ■
2022 | VOLUME 17 | ISSUE 1–2 | PAGE 11

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

Delivering Accessible Communications About 

COVID-19 to Individuals With Disabilities 

By Carolyn Phillips, Liz Persaud, and Trish Redmon, Tools for Life, Georgia’s Assistive Technology Act 

Program, Center for Inclusive Design and Innovation, Georgia Tech

The COVID-19 pandemic 

highlighted an ongoing need to 

deliver accessible communications 

to people with disabilities, their 

families, and caregivers in times of 

emergency. The Center for Inclusive 

Design and Innovation (CIDI) at 

the Georgia Institute of Technology 

(Georgia Tech) focuses on utility, 

ease of use, and high quality to 

meet such needs. CIDI’s portfolio 

of services includes accessibility 

consulting, braille services, 

captioning and audio description 

services, professional e-text 

production, and certified assistive 

technology (AT) services.

In July 2020, the CDC Foundation 

partnered with CIDI to use its full 

array of accessible communications 

services to make information from 

the Centers for Disease Control 

and Prevention (CDC) accessible 

through alternate formats for 

individuals who are blind or have 

low vision, who are deaf or hard 

of hearing, or who have cognitive 

disabilities requiring text at 

extremely low reading levels. The 

resulting products and services made 

CDC products available in digital 

and embossed braille, American 

Sign Language (ASL) videos, and 

simplified text products. 

The accessible products reached 

target audiences through a 

Georgia Tech website (http://

www.cidi.gatech.edu/covid) and 

key partnerships for the physical 

distribution of embossed braille 

products. Using its own extensive 

networks and partner networks, 

CIDI worked with the American 

Association on Health and 

Disability, a project partner, to 

construct a network of organizations 

to disseminate information about 

project services through virtual 

What is assistive technology (AT)? 

According to the AT Act of 1998 as amended in 2004, an AT device 

is “any item, piece of equipment, or product system...used to 

increase, maintain, or improve functional capabilities of individuals 

with disabilities.” An AT service is “any service that directly assists an 

individual with a disability in the selection, acquisition, or use of an 

assistive technology device” (AT Act, 2004). AT devices encompass 

a wide range of items, including magnifying glasses, large-print text, 

communication boards, canes, wheelchairs, closed captioning on 

televisions, hearing aids, communication devices with voices, and 

computers with specialized software.
2022 | VOLUME 17 | ISSUE 1–2 | PAGE 12

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

speaking appearances, webinars, and 

social media messaging to intended 

audiences. 

The project began in July 2020 and 

was extended through September 

2021 to complete new initiatives 

related to vaccines and vaccination 

guidance for people with disabilities. 

The Georgia Tech microsite 

designed to facilitate distribution 

of the accessible material continues 

through September 2022 to provide 

critical updates to online CDC 

guidance and to update a limited set 

of single-topic braille documents.

CIDI brought to the project a staff 

with a long history of broadly 

focused attention to the challenges 

of accessible communications. 

Tools for Life, Georgia’s Assistive 

Technology Act Program, through 

its coordination of the Pass It On 

Center, hosted the first national 

conference on the role of AT 

reutilization and emergency 

management in 2010.1

 The need 

for multimodal and redundant 

communication systems was 

identified as one of the non-AT 

issues of major concern at the 

conference. Through continued 

focus and ongoing partnerships, 

some participants in that conference, 

including Deaf Link, contributed to 

the solutions used in this project.

1 AT reuse activities can benefit people with disabilities 

by providing an inexpensive avenue to acquire 

equipment for independent daily living and even 

provide a temporary loan of equipment throughout a 

lengthy insurance process of getting a new wheelchair. 

Benefits reach much farther, allowing cost savings to 

Medicaid and other government-funded entities, as 

well as the environmental impact of keeping waste out 

of landfills.

With the existence of mandated 

accessibility guidelines (Section 

508 guidelines now “harmonized” 

with the Web Content Accessibility 

Guidelines, or WCAG 2.1), 

the use of plain language in 

communications, and improved 

technologies for communicating 

to people with sensory disabilities, 

why was the communication 

of healthcare guidance related 

to COVID-19 still a major 

consideration a decade after the 

2010 conference? To a large degree, 

the answer lies with inconsistent 

application of available tools and 

technologies and the need for 

better “translation” of messages 

to reach audiences with cognitive 

disabilities. Even though nearly onefourth of the population now has a 

disability, the delivery of accessible 

communication about emergencies 

still lags behind mainstream 

channels of news because it often 

requires alternate formats and 

additional time and expertise to 

prepare.

CIDI experts performed needs 

assessments for the targeted 

communication groups:

• Individuals who are blind and/

or low vision who access content 

through braille

• Individuals with intellectual or 

developmental disabilities for low/

adapted literacy materials

What is an Assistive Technology Act program?

These are programs at the state level authorized under the AT Act 

and intended to offer key AT services to people in a state, including 

AT demonstration activities, device loan activities, reutilization 

activities, and financing activities. These programs are supported by 

grants to states overseen by the Administration for Community Living. 
2022 | VOLUME 17 | ISSUE 1–2 | PAGE 13

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

• Individuals who are deaf and rely 

on ASL for communication

Subsequently, the researchers 

worked with people with disabilities 

and subject matter experts to 

conduct user accessibility testing on 

some of the initial products created 

from the project.

Serving communities with 

sensory disabilities goes beyond 

the preparation of accessible text 

documents for users of assistive 

technology. It often requires 

translation into video using ASL to 

reach individuals who are deaf or 

hard of hearing, or into embossed 

braille or braille-ready digital files 

for people who are blind or have low 

vision. CIDI staff include experts in 

both ASL services and braille. They 

recommended improved methods for 

preparation of ASL video guidance 

and supported the preparation of 

36 more accessible scripts at lower 

reading levels. CIDI’s braille team 

used its expertise and state-of-the-art 

production facility to create 2,000 

packets and more than 150,000 

pages of embossed braille, and it 

distributed those to users through 

its affiliation with the Braille 

Authority of North America and 

national library systems. Accessible 

digital files are available to users 

of refreshable braille displays and 

text-to-speech software through the 

project website.

A different issue confronted people 

with cognitive disabilities, whether 

those disabilities resulted from 

illness, injury, or developmental 

disabilities. Communications 

about health care, because of the 

complexity of the subjects, often 

remain at levels of readability 

beyond their comprehension. Plain 

language for many audiences is not 

adequate to address the need for 

communication at second or third 

grade reading levels. No solution 

for this existed at the outset of this 

project. Aware of their ongoing 

interest in this field, CIDI included 

a research team led by Dr. Karen 

Erickson from the Center for 

Literacy and Disability Studies at 

the University of North Carolina 

(UNC) at Chapel Hill in this project. 

Working with CIDI staff to test the 

development of tools, the UNC 

team formulated research-based 

guidelines for the simplification of 

text, the Guidelines for Minimizing 

the Complexity of Text (https://

cidi.gatech.edu/sites/default/

files/2021-02/Minimized%20

Text%20Complexity%20

Guidelines%20%5Bversion%20

2.03.2021%5D.pdf). These 

guidelines became the basis for 

“translating” CDC guidance to 

new levels of simplicity for this 

specific audience. The 25 resulting 

documents were posted to both 

the CDC website (https://www.

cdc.gov/coronavirus/2019-ncov/

easy-to-read/index.html) and the 

project website (https://cidi.gatech.

edu/covid/easytoread) and served 

as the basis for seven extremely 

short videos for basic COVID-19 

guidance.

The Accessible Materials Project 

also produced six national webinars 

on topics of interest related to 

COVID-19. Those remain archived 

and available on the project website.

Of ongoing concern is the 

availability of accessible 

communications for disaster 

communication of all types. The 

pandemic led to greater use of 

virtual platforms for personal 

communication, business meetings, 

healthcare appointments, and social 

gatherings, and ASL interpreters 

became more widely used for public 

communications. The accessibility 

gap persists, and much still remains 

to be done to ensure equal access to 

emergency information. ■
2022 | VOLUME 17 | ISSUE 1–2 | PAGE 14

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

California’s CCP Serves People 

With Different Abilities

By Kim Flores, M.P.P., California Mental Health Services Authority, and Valerie Nash, M.A., San Diego Refugee 

Communities Coalition

In November 2020, California 

received approval to fund CalHOPE, 

a multipronged Crisis Counseling 

Assistance and Training Program 

(CCP) to address the COVID-19 

disaster. California’s Department 

of Health Care Services (DHCS) 

established a statewide warm 

line, student support program, the 

Together for Wellness website, a 

media campaign, and a network 

of over 500 crisis counselors to 

serve Californians. California 

Mental Health Services Authority 

(CalMHSA) is contracted with 

DHCS to oversee the CCP and has 

subcontracted with 29 agencies 

that serve California’s diverse 

communities including hiring 

counselors that speak over 50 

languages.

The Substance Abuse and Mental 

Health Services Administration 

(SAMHSA) Disaster Technical 

Assistance Center (DTAC) contacted 

CalMHSA because in its review 

of the data, it found several of the 

agencies working on the California 

COVID-19 CCP were serving an 

impressive number of persons with 

different abilities. When SAMHSA 

DTAC presented CalMHSA with 

the named agencies, CalMHSA 

realized that most of them were 

culturally specific communitybased organizations (CBOs). They 

included Community Health for 

Asian Americans and the MultiEthnic Collaborative of Community 

Agencies. In further discussions with 

some of the agencies, CalMHSA 

concluded that by subcontracting 

with many CBOs that serve specific 

language and/or racial/ethnic 

communities, CalMHSA not only 

was able to reach into many of 

California’s distinct communities, 

but also ended up serving many 

more persons with intellectual and 

cognitive disabilities. This has 

occurred because when families are 

served by people who speak their 

language and/or come from their 

communities or countries, they go 

to them for all their needs and don’t 

silo the counselors as only available 

to provide mental health services. 

CalMHSA asked if any of the 

agencies would help explain this 

phenomenon, and the San Diego 

Refugee Communities Coalition 

(SDRCC) offered the following 

discussion. There are 12 agencies in 

San Diego in this coalition that serve 

African, Middle Eastern, Burmese, 

and Haitian refugees, among others. 

CalMHSA approached one of the 

agencies, the United Women of East 

Africa Support Team (UWEAST), 

about how they serve so many 

persons with intellectual and 

cognitive disabilities. Following is 

their response.

Achieving Impressive Reach

CCPs collect and use a wide range of data, including data on people 

served who have intellectual or cognitive disabilities. On average, 

CCPs find that between 2 and 3 percent of interactions involve a 

survivor with an intellectual or cognitive disability. For the CalHOPE 

California CCP, 8 percent of encounters have involved someone 

with an intellectual or cognitive disability. SAMHSA DTAC reached 

out to the California CCP to learn more about how the program has 

achieved impressive reach to this community of survivors.
2022 | VOLUME 17 | ISSUE 1–2 | PAGE 15

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

What is an ethnic communitybased organization, and how 

are they different? 

The Office of Refugee Resettlement 

(ORR) defines an ethnic communitybased organization (ECBO) as a 

“non-profit organization that was 

founded and is led by a current or 

former refugee, or a group of current 

and former refugees and immigrants, 

primarily for the advancement 

of refugees” (ORR, n.d.). What 

differentiates ECBOs from larger, 

mainstream organizations is that 

they are led and staffed by members 

of the community that they serve, 

meaning that they have unparalleled 

linguistic and cultural competency. 

This is certainly the case for the 

SDRCC. Under the direction of lead 

organization UWEAST, community 

members affected by the COVID-19 

pandemic are served by 25 parttime crisis counselors within 9 

ECBOs who collectively speak 16 

languages. 

What outreach methods are 

used to reach individuals with 

different abilities? 

The short answer is that there are 

no special outreach efforts focused 

on individuals with disabilities 

as a unique population. This was 

confirmed by conversations with 

crisis counselors. What the CCP 

has highlighted is that ECBOs such 

as Haitian Bridge Alliance, Karen 

Organization of San Diego, and 

South Sudanese Community Center 

are the go-to trusted organizations 

for their community members. The 

crisis counselors go to the same 

ethnic markets, attend the same 

mosques and churches, and live in 

the same densely populated urban 

neighborhoods as the individuals 

and families they are serving. 

Trust is based upon reputation, and 

outreach is mostly through word of 

mouth and established community 

and social media networks. 

How can you explain the large 

numbers of individuals and 

families served by the CCP 

who have physical or cognitive 

disabilities or mental health or 

substance use-related needs? 

The first thing to point out is that 

even though the numbers are high, 

the actual numbers are likely higher. 

The reasons for this are twofold. 

First, a requirement for providing 

a CCP in California is the ability 

to serve people of all different 

abilities. Second, stigma around 

cognitive disabilities and mental 

health or substance use disorders 

means that many individuals are 

undiagnosed or would be hesitant 

to disclose their diagnosis. Very few 

refugees would be familiar with 

learning disorders such as dyslexia 

or conditions such as attention 

deficit hyperactivity disorder. Of 

the families with different abilities 

served through the CCP, for the 

most part these are individuals 

and families who are known to the 

ECBOs. One of the crisis counselors 

described how she works with a 

lot of families whose children have 

autism, or where the grandparent 

is struggling with dementia. They 

have had a much more difficult time 

with COVID-19, and they have less 

access to mainstream resources and 

services due to language barriers. 

She talked about how isolated and 

afraid these families have been and 

how valuable the CCP is. Another 

who is working with the Afghan 

community shared a recent situation 

in which a client disclosed that he 

has a traumatic brain injury as the 

result of a bombing. He had lost his 

job and needed help understanding 

what benefits he was eligible for.

Moving Forward With Awareness: 

CalHOPE’s CCP has offered an 

opportunity for San Diego’s ECBOs 

to serve their communities in new 

ways. The program has allowed 

SDRCC to establish a crisis 

counseling warm line, 1–888–222–

0980, offering counseling services 

in 16 different languages. As we 

look toward life after the pandemic, 

SDRCC is committed to sustaining 

the work of crisis counselors. There 

is a need for this type of peerbased, linguistically and culturally 

competent support for all members 

of refugee communities—including 

those with different abilities. ■
2022 | VOLUME 17 | ISSUE 1–2 | PAGE 16

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

Disaster Response for the Whole Community: 

Colorado’s Work Toward Access and Functional 

Needs Integration and Community Inclusion

By Aimee Voth Siebert, M.A., Colorado Department of Public Health and Environment’s Office of Emergency 

Preparedness and Response, and the SAMHSA Disaster Technical Assistance Center

Colorado has long had processes 

and networks to work toward greater 

community inclusion, including 

inclusion of people with access 

and functional needs, in emergency 

management and disaster behavioral 

health. The Dialogue recently spoke 

with Aimee Voth Siebert, a state 

leader in disaster behavioral health 

and community inclusion, about 

community inclusion efforts in the 

state, the resilience of people with 

access and functional needs, and 

ways to foster community inclusion 

in disaster preparedness, response, 

and recovery. 

What is Colorado’s history 

of efforts to include people 

with disabilities and other 

access and functional needs 

in disaster planning and 

preparedness, response, and 

recovery?

This personal story may be helpful 

context. Part of my job title is 

Community Inclusion Coordinator. 

It used to be Vulnerable Populations 

Coordinator. Early in my tenure 

with our office, I attended a training 

hosted by Dave Schaad, our regional 

Federal Emergency Management 

Agency Disability Integration 

Specialist at the time. He looked at 

my business card and asked, “Why 

do you call your role a vulnerable 

populations coordinator?” 

I said, “We want to make sure that 

disaster responses don’t just work 

for people who are able-bodied, 

middle-income, White . . . who have 

access to their own vehicles . . . who 

speak English. We want to make 

sure we have inclusive practices for 

everyone in Colorado.” 

He said, “There it is. You don’t 

want to coordinate vulnerable 

populations; you want to coordinate 

community inclusion.” 

And I was like, “Yeah, that’s it!” 

It was great to have this new 

language as I had already been 

in conversations about the 

term “vulnerable populations.” 

When whole groups of people 

are lumped into the category of 

“vulnerable populations,” it creates 

an unfortunate mindset that often 

misses the resilience of people who 

experience and address barriers on 

a regular basis. One of my favorite 

things Dave Schaad said is, “people 

with disabilities are emergency 

managers every day.” They come up 
2022 | VOLUME 17 | ISSUE 1–2 | PAGE 17

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

with different strategies, operations 

so to speak, to get their needs 

met. Even the term “people with 

disabilities” encompasses so many 

different needs and strategies and 

resilient resources and practices. 

We recognized it wasn’t helpful

to lump entire groups into a 

“vulnerable populations” category, 

not only because those folks don’t 

necessarily identify as vulnerable, 

but also because it’s disempowering 

and emphasizes rescue rather 

than participation, which strains 

expectations on responders too. 

We shifted my title to Community 

Inclusion Coordinator. We began 

work to figure out how to have 

whole-community perspectives in 

planning and better engage resources 

from the whole community in 

eventual response. Who makes up 

the Colorado community? Where do 

they live? What types of resources 

are most relevant to their disaster 

experience? Who needs to come to 

the table?

How did you work on 

answering those questions?

The C-MIST access and functional 

needs framework from disability 

policy consultants June Kailes and 

Alexandra Enders has guided many 

efforts on our team and in our office 

over the years. 

We created the Colorado 

Community Inclusion Maps in 2013 

as an ongoing data project to help 

integrate community functioning 

and characteristics in local and 

state disaster planning. We began 

facilitating quarterly meetings of 

the Colorado Community Inclusion 

Workgroup in 2015. There were 

also significant communityled efforts that moved the state 

forward. Community groups and 

disability organizations led by the 

Independence Center, a Center 

for Independent Living (CIL)2

The C-MIST framework developed by Kailes and Enders 

(2007) promotes inclusive preparedness and response. The access 

and functional needs framework looks at people’s capabilities and 

needs, not their diagnosis, status, or group labels as was often the 

case in “vulnerable populations” or “special needs” approaches. For 

instance, the group label “stroke survivor” tells us nothing about 

an individual’s functional needs for maintaining health, safety, 

and independence, which can range from no needs to many needs. 

C-MIST is a memory tool for five functional areas that may affect 

individuals during disasters and for which resources and inclusive 

practices can be identified:

• Communication

• Maintaining health

• Independence

• Support, safety, and self-determination

• Transportation

Learn more at https://disasterstrategies.org/blog-post/definingfunctional-needs-updating-cmist-by-june-isaacson-kailesdisability-policy-consultant (Kailes, 2020).

We recognized it wasn’t helpful to lump 

entire groups into a “vulnerable populations” 

category, not only because those folks don’t 

necessarily identify as vulnerable, but also 

because it’s disempowering and emphasizes 

rescue rather than participation, which strains 

expectations on responders too.

2 Part of a program of the Administration for Community 

Living (ACL), a CIL is a nonprofit run by people with 

disabilities that provides services to help community 

members with disabilities live independently. Services 

include connection to local resources, help with job 

searches, and education about legal rights. Find CILs 

in your state at https://acl.gov/programs/centersindependent-living/list-cils-and-spils (ACL, 2021).
2022 | VOLUME 17 | ISSUE 1–2 | PAGE 18

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

in Colorado Springs, petitioned 

the Colorado legislature to create 

an access and functional needs 

program in the state Division of 

Homeland Security and Emergency 

Management. The program would 

more intentionally bring emergency 

and community preparedness efforts 

to people with disabilities and 

other access and functional needs, 

and it would integrate access and 

functional needs considerations 

into wider planning efforts. That 

program started a few years ago. 

Sadie Martinez, who used to be 

the Emergency Preparedness 

Coordinator with the Independence 

Center and had served on our 

Community Inclusion Workgroup, 

now serves as the State Access and 

Functional Needs Coordinator. 

Since the program started, we have 

worked to help Emergency Support 

Function (ESF) #5 Emergency 

Management; ESF #8 Public Health, 

Health Care, and Behavioral Health; 

and ESF #6 Mass Care partners3

 

move forward together and advance 

our collective planning by growing 

community relationships and using 

this shared language of C-MIST and 

access and functional needs. 

In 2019, we held a series of 

regional workshops as a forum for 

ESF #6, #8, and #5 partners and 

community-based organizations 

to take a snapshot of our current 

access and functional needs efforts. 

At the end of 2019, we held two 

statewide “Getting it Right” 

conferences focused on building 

knowledge and shared language 

about access and functional needs 

in Colorado. Through these events, 

two things became clear. One, we 

are not starting from scratch. A lot of 

emergency partners and community 

organizations are already building 

relationships and have begun to 

discuss barriers and resources 

affecting people they serve. And 

two, “getting it right” is a process. 

There’s more to do. We’re focusing 

on how we can start to organize that 

better with shared language, and 

where we should go from here at the 

different levels of response. 

Does Colorado participate 

in any processes to share 

work done there and lessons 

learned in community 

inclusion? 

In the past year, Sadie started 

a monthly national access and 

functional needs call involving 

people who have similar roles 

or work in access and functional 

needs planning in other states. It’s 

powerful to have space to share 

some of the challenges, insights, and 

opportunities that have come from 

approaching this cross-cutting topic 

with lots of different partners. We 

have also shared about developing 

Colorado’s Access and Functional 

Needs Program at national 

preparedness and emergency 

management conferences.

Has Colorado run into any 

challenges in including and 

meeting the needs of people 

with access and functional 

needs?

We have opportunities to further 

the inclusive practices we’ve 

been learning and apply them 

3 ESFs are part of the National Response Framework (NRF), a structured approach to disaster response at the federal level. Each ESF describes how government agencies 

and other entities will work together in a disaster. Many states, including Colorado, also use ESFs as part of state emergency planning and preparedness (https://dhsem.

colorado.gov/emergency-management/plans/state-eop). You can learn more about the NRF and ESFs at FEMA’s website at https://www.fema.gov/emergency-managers/

national-preparedness/frameworks/response.
2022 | VOLUME 17 | ISSUE 1–2 | PAGE 19

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

consistently. Because people show 

up across so much of disaster 

response, and meeting access and 

functional needs involves crossdisciplinary considerations, there 

is work to more clearly define 

access and functional needs 

roles and responsibilities among 

partners from different disciplines 

and organizations, especially in 

disaster operations where we may 

use the same functional services 

or resources. We’re still on that 

“getting it right” journey. It has been 

encouraging to see more efforts 

incorporating this thinking ahead 

of time. I give a huge shout-out to 

my colleague Reed Floarea and the 

Colorado Spirit Crisis Counseling 

Program team for modeling some of 

this work. In planning for the Crisis 

Counseling Assistance and Training 

Program grant, their team worked to 

identify and support new community 

partners they wanted involved. They 

budgeted for bilingual staff as well 

as functional services like telephonic 

interpretation and providing 

materials in languages other than 

English, and they engaged folks with 

different disabilities in review of 

materials and programming. It will 

be a great mark of progress when 

each disaster team or operation has a 

plan for what access and functional 

needs will interact with their work 

and identifies key community 

partners, resources, and services 

they will engage. 

As we have greater community 

involvement in inclusive disaster 

responses, it will also be important 

to keep talking about equity in 

effort and compensation. What 

does whole-community funding 

or compensation look like across 

traditional emergency agencies 

and newly engaged community 

organizations or resources? How 

do we address any logistical 

or administrative barriers that 

determine where funding comes 

from, who administrates it, and 

which critical community partners 

are eligible and ready to receive it?

Access and functional needs is 

whole-system and whole-community 

work. 

Based on your experience, 

are there things you would 

recommend other states do 

to ensure they reach and 

meet the needs of people with 

access and functional needs 

around disasters? 

I expect nobody is starting from 

scratch, but I like these big starting 

questions: Who makes up my 

community? How do I make sure 

that I am building thoughtful 

relationships and involving them on 

a regular basis? 

Two, regarding access and functional 

needs specifically, what works 

well for people on a regular basis? 

If we can protect the services or 

resources critical to people’s access 

and functional needs as we protect 

critical infrastructure, a hazard may 

feel less like a disaster because 

things our communities rely on are 

still available. How can we each 

incorporate what works well into 

the programs we plan and resources 

for which we budget? How can we 

support the community providers 

who render those services with 

preparedness, so they’re ready when 

a bad day comes too? 

Three, who is left out? We don’t 

enter into disasters from an equitable 

space. We have to account for 

what is creating barriers or who 

is not being invited to the table, 

who has been under-resourced or 

disempowered in daily practices. 

Disasters will either exacerbate 

inequalities that already exist, 

or—and only if we are thoughtful—

disasters can be a disruption that 

gives us a chance to do things 

differently and learn how we can be 

more equitable in future disasters 

and future community life. ■
2022 | VOLUME 17 | ISSUE 1–2 | PAGE 20

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

What It Is

Need for assistance with 

receiving disaster-related 

information

Who May Have It

People with hearing, vision, speech, and intellectual or developmental 

disabilities; people with limited proficiency in written or spoken English.

 Communication

How To Address It

• Provide people with electronic information in accessible formats (formats that can be used by people using 

assistive technologies such as screen readers).

• Use redundant and multiple methods of communicating information, including using images as well as 

words; offering translations and interpretation services for various languages, including sign languages; and 

conveying messages in person, in writing, via email, and through social media.

• Test materials with intended audiences to make sure materials convey information successfully.

What It Is

A need for medications, 

supplies, or equipment to 

survive, stay healthy, and 

maintain or return to usual 

level of functioning

Who May Have It

People with health conditions like diabetes or major depressive disorder 

that they manage with medication, people with chronic obstructive 

pulmonary disease who need oxygen supplementation, people with endstage renal disease who need dialysis.

 Maintaining Health

How To Address It

• Develop plans that account for health maintenance needs and ensure ongoing support for people with 

these needs, including ongoing supplies of medication after a disaster, backup sources of power for people 

who use machines that run on electricity, and supplies such as nebulizers.

A framework called C-MIST 

developed by June Kailes 

and Alexandra Enders 

identifies functional 

needs that community 

members may have in a 

disaster. In the C-MIST 

framework, the letters 

stand for communication; 

maintaining health; 

independence; support, 

safety, and selfdetermination; and 

transportation (Kailes, 

2020). 

THE C-MIST FRAMEWORK
2022 | VOLUME 17 | ISSUE 1–2 | PAGE 21

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

What It Is

A need for assistants, attendants, family, 

and friends to cope in new and unfamiliar 

environments; a need for support in understanding 

and remembering vital information during 

evacuation and sheltering

Who May Have It

Young children, people with intellectual disabilities, 

people with autism, people with dementia, people 

with serious mental illness leading to confusion or 

disorientation.

 Support, Safety, and Self-determination

How To Address It

• Determine needs on a case-by-case basis.

• Develop plans to reconnect people after a disaster with the loved ones, services, and supports they 

typically use to maintain functioning.

What It Is

Lack of access to personal transportation, and the 

need for accessible vehicles and transportation 

options 

Who May Have It

People who do not own their own vehicles, people 

who use wheelchairs and other supports for 

mobility and who need assistance with getting into 

and out of vehicles.

 Transportation

How To Address It

• Develop plans that account for the needs of individuals without personal vehicles and who need accessible 

transportation.

• Provide information to the public about how to find and use accessible transportation in an evacuation.

What It Is

“The overarching goal, the steady state that the 

individual wants to maintain in an emergency” 

(Kailes, 2020)

Who May Have It

The whole community. Many people after a 

disaster will need help of some sort to maintain 

independence.

 Independence

How To Address It

• Address the other functional needs in the model.
2022 | VOLUME 17 | ISSUE 1–2 | PAGE 22

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

“Help Where You Are and Hope When You 

Need It”: Meeting the Diverse Needs of Ohio’s 

Residents in a Pandemic

By Christine Sielski, M.S.W., and Kirsten Brownlee, Ohio Department of Mental Health and Addiction Services

The success of Ohio’s Crisis 

Counseling Assistance and Training 

Program (CCP) Regular Services 

Program (RSP) grant is credited 

to a multifaceted implementation 

approach of providing timely access 

to resources for Ohioans affected by 

the COVID-19 pandemic.

Engagement Strategies 

To Reach Individuals With 

Functional and Access Needs

The program targeted outreach and 

referral services for Ohioans with 

physical, intellectual/cognitive, 

and mental health issues and/

or substance use disorders. In the 

process of connecting with people 

about their needs, it was discovered 

that a lack of familiarity with 

technology is itself a functional 

need brought to the forefront during 

the pandemic. People with multiple 

functional and access needs, such 

as mobility issues paired with 

lack of technology in the home or 

unfamiliarity with using computers 

and video platforms, benefited from 

the program. 

The CCP staff began assisting 

Ohioans by meeting them where 

they were. Creative and culturally 

diverse staff brought a new level 

of sensitivity and competence, 

implementing boots-on-the-ground 

best practices working with people 

with different abilities. To reach 

those with mobility constraints, staff 

went door to door, adhering to safety 

protocols while offering outreach 

contacts and service referrals. For 

those who faced technological 

barriers to receiving assistance, staff 

Achieving Impressive Reach

CCPs collect and use a wide range of data, including data on people 

served who have intellectual or cognitive disabilities. On average, 

CCPs find that between 2 and 3 percent of interactions involve 

a survivor with an intellectual or cognitive disability. For one of 

Ohio’s CCPs, 11 percent of encounters involved someone with an 

intellectual or cognitive disability. The SAMHSA Disaster Technical 

Assistance Center reached out to the Ohio CCP to learn more about 

how the program has achieved impressive reach to this community 

of survivors.

A group of Ohio RSP staff shares resources with community members. Photo provided by Ohio CCP.
2022 | VOLUME 17 | ISSUE 1–2 | PAGE 23

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

worked to secure free computers 

and make in-person visits to provide 

resources that trained people on 

using technology to meet their needs. 

They also assisted parents in meeting 

the educational needs of children 

who were learning from home.

Local provider agencies developed 

screening forms to identify physical 

and mental health needs. Staff then 

conducted the initial telephone 

outreach, and when possible, 

conducted follow-ups in person. 

In some instances, staff took the 

forms to the in-person meetings and 

read them to those with hearing, 

sight, and literacy issues. Another 

important discovery was that inperson contacts supported the needs 

of Ohioans who may have been 

uncomfortable in group settings. The 

isolation and loneliness that people 

with disabilities experienced during 

the pandemic was alleviated through 

this outreach, and clients expressed 

gratitude for these in-person visits. 

While conducting in-person visits, 

CCP staff modeled important selfprotection precautions like how to 

correctly wear a mask and practice 

good hygiene. Ongoing education 

provided in a user-friendly manner 

specific to each group was critical 

to reducing further anxiety for 

recipients of assistance. For 

example, techniques were simplified, 

using pictures so everyone could 

understand the information being 

conveyed. This proved an essential 

“best practice” for people with 

cognitive, intellectual, or other 

disabilities to ensure information 

was provided in an understandable 

way.

Due to closures of other agencies, 

CCP staff explored new outreach 

methods to connect with Ohioans 

needing substance use and mental 

health treatment. This included 

finding transportation to services 

as well as providing connections 

to food pantries and organizations 

that could offer assistance with 

rent and utility payments. Nurse 

practitioners came to local agency 

sites to dispense vaccines and 

provide education for those who 

were apprehensive about receiving 

the vaccine. CCP staff even helped 

connect an Ohioan who uses a 

wheelchair with a resource to sell his 

handmade crafts. This allowed him 

to receive income to provide for his 

basic needs while also enhancing 

his self-esteem and improving his 

mental health.

Management Strategies 

To Support Inclusion and 

Resource Sharing

“Help where you are” and “hope 

when you need it” branding was 

used in public awareness campaigns 

and informational materials about 

Ohio’s COVID Care Program, and 

CCP staff often wore T-shirts with 

this branding. When in-person 

contact was not available, staff sent 

out informational postcards and 

flyers. The Ohio CareLine, crisis 

lines, and local hotlines also referred 

callers who needed additional 

assistance to CCP staff so that 

information about the program could 

be shared and referrals provided via 

phone or video.

In 2019, more than 3 million U.S. children,

or about 1 in 23 children in the United States (4.3 percent), 

had a disability.

 Source: Young, 2021

Image provided by Ohio CCP.

The implementation of the program 

included monthly technical 

assistance calls held by the Ohio 

Department of Mental Health and 

Addiction Services (OhioMHAS) 

with RSP provider staff to answer 

questions, help with technology 

issues, and create a statewide team 
2022 | VOLUME 17 | ISSUE 1–2 | PAGE 24

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

approach to the work. During 

these webinars, staff from the 

various provider agencies were 

able to share details regarding 

accomplishments and barriers 

experienced in their local programs. 

A steering committee also formed 

and met each month to discuss 

program updates, collect data, and 

explore collaboration opportunities. 

OhioMHAS offered “provider 

mentorship,” which matched new 

provider agencies with agencies who 

had participated in the Immediate 

Services Program grant. 

OhioMHAS also developed a 

directory of CCP staff; this directory 

was shared with all providers 

to increase connection points, 

collaboration, and networking 

opportunities. Additionally, staff 

were brought together for trainings 

required by SAMHSA and Question, 

Persuade and Refer Gatekeeper 

suicide prevention trainings. Local 

Alcohol, Drug Addiction, and 

Mental Health (ADAMH) boards 

included CCP staff in their agency 

trainings, which provided increased 

visibility to CCP staff within local 

provider agencies. Recognizing the 

unique working situation during the 

pandemic and the possibility of staff 

burnout, OhioMHAS administered 

a quarterly stress survey for all 

CCP staff. Data shows that most 

staff consistently scored “never” or 

“rarely” experiencing stress from 

working in the current environment. 

In fact, staff instead reported high 

levels of job satisfaction. Both 

the recipients of assistance and 

CCP staff have shared that making 

meaningful connections with others 

during a time when many people felt 

isolated or helpless had a positive 

effect on their mental health. 

Peer Support Strategies To 

Address Community Needs

It is important to recognize the 

paraprofessional staff who were 

instrumental to the program’s 

success. Ohio’s CCP staff comprises 

paraprofessional peer supporters, 

most of whom have lived experience 

of mental illness or substance use 

disorder. They worked diligently 

to provide outreach, referral, 

and community education while 

establishing a visible presence in 

their board region and across the 

state. Although tasked with outreach 

and referral, they often went a step 

further and included follow-up to 

make sure that Ohioans were able to 

connect with other needed resources. 

This was how it was discovered 

that some populations required 

help registering for a COVID 

vaccine, and staff created a network 

between hospitals and local provider 

agencies to provide registration 

and transportation for vaccines. For 

non-English-speaking Ohioans, 

RSP peer supporters and provider 

agencies created COVID healthcare 

and vaccine materials in six different 

languages that were then used with 

minority populations. 

In summary, the COVID-19 

pandemic presented tremendous 

challenges, but it also presented 

opportunities to innovate and 

enhance access and pathways to 

care. The success of Ohio’s RSP 

program is a strong example of this 

innovation and a testament to the 

commitment of the program staff 

to live out their mission of offering 

“help where you are” and delivering 

“hope when you need it.” ■
2022 | VOLUME 17 | ISSUE 1–2 | PAGE 25

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

How Service Animals Empower People 

With Disabilities in Disasters

By Charlotte Stasio and Cg Garrard, M.A., Griffin LLC

A service animal should be treated 

the same as any medical device: a 

personal possession essential for 

the user to thrive in daily life. Just 

like a wheelchair, a service animal 

ideally would not be handled by 

anyone other than the person with a 

disability. This can make it difficult 

during and after disasters when 

responders and support personnel 

might need to interact with an 

animal whose handler needs help. 

Knowing what to expect is the first 

step to ensuring positive interactions 

in such cases and ultimately 

improving mental health and stress 

management capabilities of the 

people who rely on these incredible 

animals. 

Service Animals and People 

With Disabilities

Service animals are dogs (or 

sometimes miniature horses) that 

are individually trained to do 

work or perform tasks for people 

with disabilities, as defined by the 

Americans with Disabilities Act 

(ADA) (https://www.ada.gov/

regs2010/service_animal_qa.html). 

An individually trained animal 

is one that has been trained for a 

particular person to take specific 

actions that are needed to assist 

with that person’s disability. It is 

important to know that service 

animals are not the same as 

emotional support animals, therapy 

dogs, or other working dogs. These 

companions can be extremely 

helpful to the people they serve, but 

they do not meet the requirements as 

outlined in the ADA. 

There are many things that we 

as humans cannot control. For 

people with disabilities that feeling 

of restriction may be enhanced, 

particularly in times of crisis. All 

disabilities are different, in the 

same way that every single person 

is different. Emergency managers, 

mental health practitioners, and 

responders should not make 

assumptions about the capabilities of 

a person or service animal. The best 

way to help people with disabilities 

is by recognizing and supporting 

their control over the things they 

have authority over. When we do 

this, we empower people to ask for 

what they need.

Animals With Jobs

Service animals need to concentrate 

on the incredibly important job of 

keeping their handlers safe. This is 

often noted on the vests they wear 

with phrases such as “do not pet,” 

“ignore me,” or “do not distract” 

(but, according to the ADA, a 

service animal is not required to 

wear a vest or harness). Many 

people do not realize service animals 

are working at all times—they 

are closely attuned to signs from 

their handler, ready to take action 
2022 | VOLUME 17 | ISSUE 1–2 | PAGE 26

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

if needed. In fact, many service 

animals are trained to respond 

to signs of heightened stress or 

discomfort in their handler. 

As an example, say that a service 

dog has been individually trained 

to assist their handler with 

posttraumatic stress disorder, which 

affects the central nervous system 

and can cause panic attacks, loss 

of awareness, and other symptoms 

that could be dangerous if they 

occurred when a person was not 

in a safe place. That is where the 

service dog comes in. Their service 

dog may perform over a dozen 

specially trained tasks in about a 

half hour, including retrieving and 

delivering medication, preventing 

injury, and comforting their handler. 

That is why it is so important not 

to interrupt service animals when 

they are working, even if wellintentioned. They have an important 

job, and they need all their attention 

to do it. 

Service Animals in a Disaster

Now, say a service dog’s handler is 

hurt as a result of an incident. When 

emergency responders arrive, it will 

be incredibly important that they do 

not separate the service dog from the 

handler.

Emergency responders do not 

need to spend time figuring out if 

a service dog is legitimate. If the 

dog is not a safety risk, it should 

remain with its owner, where it can 

continue to provide physical and 

psychological support. This will 

allow emergency responders to care 

for the handler—and the animal 

might even provide help by alerting 

responders to medical emergencies. 

Furthermore, by separating a 

person from their service animal, 

responders run the risk of creating 

additional psychological or 

emotional distress. For mental health 

and substance use disorder treatment 

practitioners in the recovery phase of 

an incident, the service animal will 

continue to be a source of support and 

comfort for their patients. 

The only circumstances where 

service animals should be separated 

from their handler is in the case of 

a legitimate safety risk, according 

to the ADA (https://www.ada.

gov/service_animals_2010.htm). 

Legitimate safety risks would include 

an animal who is out of control, not 

housebroken, or in an environment 

that requires sterility, such as a burn 

unit or operating room. Basically, 

anywhere a person needs to wear 

full personal protective equipment 

(PPE) is a place the service animal 

cannot go.

If the animal’s presence would 

interfere with lifesaving care, that 

could also be considered a safety 

risk. Personnel should arrange for the 

animal to be reunited with its owner 

as soon as possible. Advocates in 

the form of a family member, friend, 

neighbor, or even one of the personnel 

themselves may be employed to look 

after the service animal.

Common Goals

Ultimately, both emergency 

management professionals and 

service animals share the same goals 

in a disaster—to provide lifesaving 

and stabilizing support to a person 

with a disability and ensure their 

successful recovery. There will 

be better outcomes for everyone 

involved in a disaster scenario when 

we understand the roles service 

animals play in keeping their owners 

safe, mentally well, and able to 

manage stress. ■

Photo provided by Griffin LLC.
2022 | VOLUME 17 | ISSUE 1–2 | PAGE 27

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

RECOMMENDED RESOURCES

Disaster Safety for People With Disabilities

This web page from the American Red Cross can help 

individuals with disabilities and their families plan 

ahead for an emergency by assembling a survival kit, 

making an emergency plan, and being informed. The 

page also provides a series of questions to help you 

think about what you may need before, during, and 

after a disaster. Included is a video about emergency 

preparedness information for those who use American 

Sign Language or closed captioning. 

This web page is available at 

https://rdcrss.org/3BlMywd. 

Access and Functional Needs Toolkit: 

Integrating a Community Partner Network To 

Inform Risk Communication Strategies

This toolkit developed by the Centers for Disease 

Control and Prevention (CDC) helps emergency 

planners effectively communicate public health 

information to people with disabilities and other access 

and functional needs. This toolkit includes things to 

consider in your planning, examples, and resources that 

can guide you in planning risk communication messages 

to help people stay safe.

Find the toolkit at https://bit.ly/3GroWtE. 

Preparing Makes Sense for People With 

Disabilities, Others With Access and Functional 

Needs and the Whole Community

This brochure from Ready.gov highlights how to create 

an emergency plan that fits your needs. This includes 

creating a list of family, friends, and others who will be 

a part of your personal support network if you anticipate 

needing support during a disaster. It also provides 

information on how to include your service animal in 

your emergency plan, and what emergency documents, 

medications, and medical supplies to include in your 

emergency kit. 

The brochure is available at https://bit.ly/3vWGFEm. 

Safety and Children With Disabilities: Keeping 

Children With Disabilities Safe in Emergencies

This web page from the CDC provides tips to help 

protect your family and child with a disability during an 

emergency situation. Children with disabilities may have 

a hard time relocating, communicating, or adjusting, and 

preparing ahead of time can help ease some of the stress 

and confusion involved in an emergency. The page 

offers suggestions on preparing an emergency kit and 

making a plan and has additional resources for families, 

caregivers, and healthcare practitioners.

This page is available at https://bit.ly/31dpnrw. It is 

also available in Spanish at https://bit.ly/3vULL42.
2022 | VOLUME 17 | ISSUE 1–2 | PAGE 28

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

Recent Technical Assistance Requests

In this section, read about responses SAMHSA Disaster Technical Assistance Center (DTAC) staff have provided to 

recent technical assistance (TA) requests. Send your questions and comments to dtac@samhsa.hhs.gov.

Request: The Supporting Healthy Aging Resource 

& Education (SHARE) Network in Chicago requested 

SAMHSA DTAC host a presentation about older adults 

in disasters for their stakeholders after receiving a 

SAMHSA DTAC Bulletin on the topic. The SHARE 

Network noted their audience was interested in disaster 

planning guidance for special populations and would 

benefit from tips and resources.

Response: SAMHSA DTAC collaborated with the 

SHARE Network and developed a presentation for their 

audience and stakeholders during a network meeting 

at which almost 40 members received information and 

resources about vulnerable populations and disaster 

planning. Below are some of the resources provided:

 Helping Older Adults After Disasters: A Guide to 

Providing Support—This guide from SAMHSA 

provides tips and resources for outreach staff working 

with older adults after disasters.

https://store.samhsa.gov/product/helping-olderadults-after-disasters-a-guide-to-providingsupport/PEP19-01-01-001 

 TAP 34: Disaster Planning Handbook for Behavioral 

Health Service Programs—This guide in the 

Technical Assistance Publication (TAP) series by 

SAMHSA provides guidance for mental health 

and substance use disorder treatment and services 

programs in disaster planning.

https://store.samhsa.gov/product/tap-34-disasterplanning-handbook-for-behavioral-health-serviceprograms/pep21-02-01-001 

 Working With Older Adults and People With 

Disabilities: Tips for Treatment and Discharge 

Planning—This fact sheet from the U.S. Department 

of Health and Human Services Office of the Assistant 

Secretary for Preparedness and Response includes 

important considerations and tips for service 

providers supporting older adults and individuals with 

disabilities.

https://www.phe.gov/Preparedness/planning/abc/

Documents/older-adults_disabiliities.pdf 

 Building Resilience in Older Adults—This toolkit 

from the RAND Corporation provides community 

members, organizations, health department officials, 

and disaster planners with information and activities 

for supporting disaster resilience in older adults.

https://www.rand.org/pubs/tools/TL282/

introduction.html 

Request: A certified peer recovery specialist 

in Delaware contacted SAMHSA DTAC seeking 

information on the Crisis Counseling Assistance and 

Training Program (CCP). The individual also asked 

for assistance finding trainings for those interested in 

delivering services to communities experiencing need 

during the COVID-19 pandemic.

Help Improve SAMHSA’s Disaster 

Services and Products

As a subscriber to this 

newsletter, you are 

invited to participate 

in a short, web-based 

survey to provide the 

SAMHSA Disaster 

Technical Assistance Center (DTAC) with 

feedback about your experiences with our 

products and services. The survey should take no 

more than 15 minutes. Complete the survey by 

clicking on this link, or copy and paste the URL 

https://iqsolutions.qualtrics.com/jfe/form/SV_

bjYCSJDUQAGi1h3 into your web browser.
2022 | VOLUME 17 | ISSUE 1–2 | PAGE 29

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

Response: SAMHSA DTAC shared information 

regarding the administration and mission of the CCP 

to provide services to those affected by disasters. 

SAMHSA DTAC provided the following online 

trainings available for disaster behavioral health 

professionals.

 Crisis Counseling Assistance and Training Program 

Trainings—This series of trainings delivered to CCP 

staff can be adapted and used by other entities to train 

staff to be ready for crisis response.

https://www.samhsa.gov/dtac/ccp-toolkit/trainyour-ccp-staff 

 Psychological First Aid—This free online course 

provided by the National Child Traumatic Stress 

Network (NCTSN) includes a 6-hour interactive 

training that places the participant in the role of a 

practitioner in a post-disaster scene.

https://learn.nctsn.org/enrol/index.php?id=555 

 Skills for Psychological Recovery (SPR)—This free 

online course provided by NCTSN teaches participants 

about SPR, an intervention to help survivors gain 

skills during longer term disaster recovery to manage 

distress and cope with stress. 

https://learn.nctsn.org/enrol/index.php?id=535 

 American Red Cross Online Training Modules—

The American Red Cross offers various free online 

trainings on disaster-related topics, including disaster 

mental health.

https://www.redcross.org/take-a-class/disastertraining 

 Community Emergency Response Team (CERT) 

Program—Created by the Federal Emergency 

Management Agency, this program educates people 

about disaster preparedness by training participants in 

basic disaster response skills.

https://www.ready.gov/cert 

Request: SAMHSA DTAC received a TA request 

from the New Jersey Attorney General’s Office 

looking to train first responders on best practices when 

interacting with individuals experiencing mental health 

and substance use-related crises. 

Response: SAMHSA DTAC shared information 

regarding the following free online trainings designed 

for first responders.

 First Response—This course addresses the mental 

and physical stressors faced by firefighters, emergency 

Check out the new and updated 

SAMHSA DTAC Disaster Behavioral Health Information Series (DBHIS) installments.

Are you looking for disaster behavioral health resources?

https://www.samhsa.gov/resource-search/dbhis
2022 | VOLUME 17 | ISSUE 1–2 | PAGE 30

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

medical services personnel, and police when 

responding to opioid overdose calls.

https://www.samhsa.gov/dtac/first-responderstraining

 Shield of Resilience—Created specifically for law 

enforcement personnel, this course helps officers 

learn to recognize symptoms of stress, depression, 

posttraumatic stress disorder, and risk of suicide.

https://www.samhsa.gov/dtac/shield-resiliencetraining-course

 Service to Self—Created specifically for fire and 

emergency medical services personnel, this course 

addresses occupational stressors and includes 

demonstrations of stress management techniques. 

https://www.samhsa.gov/dtac/service-to-selftraining-course

SAMHSA DTAC also provided the following resources 

regarding self-care and stress management for first 

responders.

 Helping Staff Manage Stress When Returning to 

Work: Tips for Supervisors of Disaster Responders—

This tip sheet from SAMHSA provides supervisors 

tips for helping disaster responders transition back to 

work after they have been deployed to serve as part of 

a response effort.

https://store.samhsa.gov/product/Helping-StaffManage-Stress-When-Returning-to-Work/sma14-

4871

 Preventing and Managing Stress: Tips for Disaster 

Responders—This tip sheet from SAMHSA provides 

disaster responders tips for managing stress before, 

during, and after their assignments. 

https://store.samhsa.gov/product/Preventing-andManaging-Stress/SMA14-4873

 Returning to Work: Tips for Disaster Responders—

This tip sheet from SAMHSA offers disaster 

responders tips for transitioning back to routine work 

after disaster deployment. 

https://store.samhsa.gov/product/Returning-toWork/SMA14-4870

 Understanding Compassion Fatigue: Tips for 

Disaster Responders—This tip sheet from SAMHSA 

explains the causes and signs of compassion fatigue 

and provides self-care tips. 

https://store.samhsa.gov/product/UnderstandingCompassion-Fatigue/sma14-4869

 First Responders: Behavioral Health Concerns, 

Emergency Response, and Trauma—This edition 

of the SAMHSA DTAC Supplemental Research 

Bulletin explores mental and substance use disorderrelated risks faced by first responders as a consequence 

of their work, risk and protective factors, and 

interventions in support of first responder mental 

health. 

https://www.samhsa.gov/sites/default/files/dtac/

supplementalresearchbulletin-firstrespondersmay2018.pdf
2022 | VOLUME 17 | ISSUE 1–2 | PAGE 31

A Quarterly Technical Assistance Journal on Disaster Behavioral Health 

Produced by the SAMHSA Disaster Technical Assistance Center

REFERENCES

The Dialogue is not responsible for the 

information provided by any web pages, 

materials, or organizations referenced 

in this publication. Although The 

Dialogue includes valuable articles and 

collections of information, SAMHSA 

does not necessarily endorse any 

specific products or services provided 

by public or private organizations 

unless expressly stated. In addition, 

SAMHSA does not necessarily endorse 

the views expressed by such sites or 

organizations, nor does SAMHSA 

warrant the validity of any information 

or its fitness for any particular purpose.

The views, opinions, and content 

expressed in this publication do not 

necessarily reflect the views, opinions, 

or policies of the Center for Mental 

Health Services (CMHS), the Substance 

Abuse and Mental Health Services 

Administration (SAMHSA), or the U.S. 

Department of Health and Human 

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Center for Disaster Philanthropy. (n.d.). 

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Mann, M., McMillan, J. E., Silver, E. 

J., & Stein, R. E. K. (2021). Children 

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Prepare • Respond • Recover

Inform • Assist

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The SAMHSA Disaster Behavioral Health Information Series contains resource collections 

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CONTACT US

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Toll-free: 1–800–308–3515 

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