Hon. Mark Shriver 

Chairperson 

Michael Anderson, M.D. 

Vice-Chairperson 

Ernest Allen, J.D. 

Merry Carlson 

Hon. Sheila Leslie 

Bruce Lockwood 

Gregg Lord 

Irwin Redlener, M.D. 

David Schonfeld, M.D. 

Lawrence Tan, J.D. 

Christopher Revere 

Executive Director 

NATIONAL COMMISSION ON

CHILDREN AND DISASTERS

Progress Report on 

Children and Disasters 

U.S. Agencies Take Modest Steps 

To Achieve Commission Goals 

May 11, 2010 
National Commission on Children and Disasters 

Progress Report on Children and Disasters 

May 11, 2010 

2

INTRODUCTION

The National Commission on Children and Disasters is a bipartisan, independent body created 

under federal law (P.L.110-161) to assess children’s needs as they relate to preparation for, 

response to and recovery from all hazards, including major disasters and emergencies. The 

Commission is required to report its findings and recommendations to the President and 

Congress. 

On October 14, 2009, the Commission delivered an Interim Report to President Obama and 

Congress. This follow-up report represents the Commission’s desire to track relevant federal 

agency progress at a point mid-way between the Interim Report and the delivery of its next 

report in October 2010. In February 2010, Commission Chairperson Mark Shriver sent an 

official request for a status update and a response template (see Appendix A) to the Secretaries of 

the Department of Homeland Security/FEMA, Department of Health and Human Services, 

Department of Education, Department of Housing and Urban Development, Department of 

Justice and Department of Defense. All agencies responded. The Commission reviewed each 

response and sought follow-up information or clarification from agencies when necessary. As 

agencies move forward, it is important for them to develop measurable goals to guide 

implementation efforts and to facilitate better accountability for their progress. 

In the seven months since the delivery of the Interim Report, federal agencies have taken positive 

steps to implement the Commission’s recommendations, but bold and swift action is needed to 

achieve and sustain the desired outcomes of the Commission. One would presume that H1N1 

and recent disasters in American Samoa and Haiti, where children make up an exceptionally 

large portion of the population, coupled with the forecast of a severe hurricane season beginning 

June 1, would motivate the federal government to adopt a more proactive and urgent approach to 

protect children. The status quo is unacceptable and children - 25% of our population - cannot 

continue to remain needlessly vulnerable. 

At this stage, it is abundantly clear that a National Strategy for Children and Disasters is 

required to command better integration, coordination and outcomes from within the White 

House and across the spectrum of federal agencies and state, Tribal, local, community and nongovernmental partners. The Interim Report provided a blueprint. In many instances, critical 

recommendations in the Interim Report remain substantially unaddressed, leaving 

children vulnerable in disasters. Only a charge of urgency and innovation from the 

President, Cabinet members and leaders in Congress will bring about the changes and 

achievement necessary to meet the unique needs of children. 

The Commission unanimously approved this report on May 11, 2010. 
National Commission on Children and Disasters 

Progress Report on Children and Disasters 

May 11, 2010 

3

PROGRESS REPORT FINDINGS AND RECOMMENDATIONS

KEY

DHS/FEMA: Department of Homeland Security/Federal Emergency Management Agency 

HHS: Department of Health and Human Services 

ED: Department of Education 

DOJ: Department of Justice 

HUD: Department of Housing and Urban Development 

DoD: Department of Defense 

Interim Report Recommendation 1.1: Distinguish and comprehensively integrate the needs of 

children across all inter- and intra-governmental disaster planning activities and operations. 

FEMA Administrator Craig Fugate created a Children’s Working Group in August 2009. The 

Working Group serves as a platform across FEMA to integrate the needs of children into 

policies, programs and operations. With guidance from the Commission, the Working Group is 

also coordinating and assisting in the development of disaster planning activities for children 

with sister agencies, most notably HHS, DOJ and ED, and non-governmental stakeholders. 

DHS/FEMA incorporated children into fiscal year (FY) 2010 Homeland Security Grant Program 

(HSGP) planning guidance and is undertaking new initiatives to incorporate children into 

planning, training and exercising toolkits and documents for non-federal partners and emergency 

management and response personnel, including revisions to FEMA’s Comprehensive 

Preparedness Guidance 101 and the National Response Framework. The Commission looks 

forward to working with FEMA to complete these planned activities and subsequent efforts to 

further integrate the needs of children throughout disaster planning activities and operations. 

Within HHS, Dr. Nicole Lurie, Assistant Secretary for Preparedness and Response (ASPR) and 

Carmen Nazario, Assistant Secretary for the Administration for Children and Families (ACF) 

will co-chair an HHS inter-departmental working group on children and disasters, which reports 

to Secretary Kathleen Sebelius. The first meeting is planned for May 21, 2010. HHS recognizes 

the need to assess its current capabilities and facilitate coordination across the agency. In this 

sense, forming a working group is an important step, but the working group is a means to 

achieve progress, not an indicator of progress. The Commission finds that significant gaps 

remain unaddressed and expects that the working group will develop and provide the 

Commission with a strategic plan addressing how HHS will implement the Commission’s 

recommendations, in addition to other HHS policy and program actions. 

ASPR has organized and attended stakeholder meetings for information gathering and discussion 

on policy gaps in addressing the needs of children, particularly as they relate to medical response 
National Commission on Children and Disasters 

Progress Report on Children and Disasters 

May 11, 2010 

4

and medical countermeasures. The Commission awaits a decision from ASPR on various 

recommendations produced from these meetings and an implementation strategy. The 

Commission requested that all future comparable meetings include adequate pediatric 

representation in the planning, implementation, and analysis and reporting of findings. 

In addition, the Hospital Preparedness Program (HPP) provides opportunities to support pediatric 

needs, however only eleven FY 2009 funded activities specifically focused on children. In 

order to increase awareness of funding eligibility for pediatric initiatives, the Commission 

requests that children be specifically referenced throughout future HPP grant guidance, 

similar to DHS’ FY 2010 HSGP grant guidance, rather than grouped within a subset of 

“at-risk” population preparedness needs. In addition, HPP should highlight and share 

pediatric funded activities and best practices with hospitals and eligible health care 

systems. 

The Centers for Disease Control and Prevention (CDC) created an ad-hoc Children’s Health 

Team in response to H1N1 and the experience highlighted the unique needs of children and the 

need to provide guidance for families, practitioners and persons with daily responsibility for 

children (i.e. school and child care staff). CDC intends to establish a clear responsibility for 

children within the portfolio of policy and disaster response staff and assemble a pediatric expert 

working group at CDC to be trained and ready for future emergency responses. The Commission 

urges CDC to operationalize these efforts quickly and further recommends that CDC consult 

non-federal pediatric experts (physicians and nurses) to assist in developing the training 

program. 

1.2: Accelerate the development of a National Disaster Recovery Strategy with an explicit 

emphasis on addressing the immediate and long-term physical and mental health, educational, 

housing and human services recovery needs of children. 

In October 2009, President Obama formed the White House Long Term Disaster Recovery 

Working Group, which is co-chaired by DHS Secretary Janet Napolitano and HUD Secretary 

Shaun Donovan. The working group is required to produce a report to the President and a 

National Disaster Recovery Framework (NDRF). The Commission is not a member of the 

working group but has submitted public comment1

 noting a “conscious effort” to incorporate 

children throughout the document, but highlighting several areas in need of improvement or 

clarity, as they relate to this recommendation and subsequent findings. The Commission is 

unable to report further at this time, as the White House has not released the report to the 

President or the NDRF (expected June 1, 2010). The Commission will carefully review the 

documents and report findings and recommendations to the President and Congress. 

 

1

 See: http://www.childrenanddisasters.acf.hhs.gov/20100224_NCCD_NDRFCommentsV04FINAL.pdf
National Commission on Children and Disasters 

Progress Report on Children and Disasters 

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5

2.1: Integrate mental and behavioral health for children into all public health and medical 

preparedness and response activities. 

HHS has several operating divisions with responsibility for developing disaster mental and 

behavioral health capabilities. The Commission and the National Biodefense Science Board have 

called for the creation of a Concept of Operations (CONOPS) document to address the need for 

more formalized coordination and planning of federal and non-federal partners in the event of an 

emergency or disaster. HHS indicated that development of this CONOPS would require the 

designation of a lead agency, with designated authority and funding. The Commission finds 

that a significant gap remains unaddressed and strongly urges the HHS Children’s 

Working Group to submit a strategy to Secretary Sebelius to develop disaster mental and 

behavioral health capabilities for children and produce the CONOPS. 

2.2: Enhance the research agenda for children’s disaster mental and behavioral health, 

including psychological first aid, cognitive-behavioral interventions, social support 

interventions and bereavement counseling and support. 

The National Institutes of Health (NIH) supports establishing a working group to coordinate 

agency efforts and minimize gaps in research. NIH indicated that the working group could 

recommend a national research agenda and also develop strategies to disseminate and 

communicate important findings. NIH also indicated that potentially, an annual review of 

research on children’s disaster and mental health research could be conducted via the Behavioral 

and Social Sciences Consortium. The Commission finds that a significant gap remains 

unaddressed in enhancing disaster mental and behavioral health research as envisioned in 

the recommendation and recommends NIH lead these activities, in partnership with the 

Substance Abuse & Mental Health Services Administration (SAMHSA), CDC, ASPR and, 

as appropriate, FEMA. 

2.3: Enhance pediatric disaster mental and behavioral health training for professionals and 

paraprofessionals, including psychological first aid, cognitive-behavioral interventions, social 

support interventions and bereavement counseling and support. 

SAMHSA reports the National Child Traumatic Stress Initiative has developed a range of 

materials, including psychological first aid and skills for psychological recovery, which can be 

used for children and families. In addition, through the Crisis Counseling Program, 

paraprofessionals and professionals have been trained to provide crisis counseling services to 

children and families through schools and faith-based organizations after several disasters. 

While these efforts to date are worthwhile, they pre-date the establishment of the 

Commission and do not respond to the Commission’s recommendations for a broadening 

of the nature and scope of disaster mental health training provided. The Commission is 

awaiting further clarification from SAMHSA and FEMA about potential enhancements to 
National Commission on Children and Disasters 

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6

the Crisis Counseling Program and how they will better respond to the recommendations 

of the Commission. 

The Indian Health Service indicated that it will implement aspects of the recommendation over 

the next 18 months for all providers who work with children in disasters. The Commission 

supports these efforts and seeks a commitment from other operating divisions within HHS to 

expand outreach and training efforts and provide pediatric disaster mental and behavioral health 

training to a larger consortium of professionals and paraprofessionals. 

3.1: Ensure availability and access to pediatric medical countermeasures at the federal, state and 

local level for chemical, biological, radiological, nuclear and explosive (CBRNE) threats. 

HHS acknowledges research, regulatory, financial and market gaps and barriers to developing 

medical countermeasures (MCMs) for children. The Commission continues to be deeply 

troubled by the lack of legal authority for HHS to authorize pediatric indications, prior to 

approval by FDA, to meet the most pressing needs for ready availability of MCMs during 

an emergency. The Commission awaits a report from HHS on its end-to-end review of MCM 

development and the Emergency Use Authorization process and strongly urges that the report 

include recommendations on how to address fundamental challenges regarding children. 

Few MCMs are FDA-approved for use in children. As a result, HHS has procured a limited 

number of pediatric MCMs for the Strategic National Stockpile (SNS), including treatments for 

radiation, pandemic influenza and nerve agents. However, a significant disparity exists in the 

amount of MCMs procured for children compared with adults. The Commission recommends 

HHS, as a matter of policy, place pediatric and obstetric preparedness on par with - or in 

some cases a higher priority than - the general population, to inform future SNS funding 

requests. 

The Commission recommended that HHS form an advisory body to advise the Secretary on 

issues pertaining specifically to MCMs for children. Currently, such considerations and activities 

are spread across the agency, with insufficient coordination or formal structure and leadership. 

For example, HHS has identified research and development needs and regulatory issues, yet no 

funding has been made available to address these gaps. Another significant gap is the lack of 

proper pediatric dosing information for the majority of existing MCMs.2

 Using an expert 

pediatric advisory body, HHS should continually review the best available data on medications 

and provide expert consensus on the proper dosing and dispensing of MCMs to children, as well 

as support appropriate clinical trials. HHS has not indicated an intention to form such an 

advisory body, instead suggesting that it be formed as a standing committee to an existing 

advisory body with broader scope beyond children. The Commission believes this 

approach is insufficient and requests the implementation of its recommendation to form a 

separate pediatric advisory body. 

 

2

 National Biodefense Science Board. Where Are the Countermeasures?: Protecting America’s Health from CBRN 

Threats. March 2010. Available from: http://www.hhs.gov/aspr/omsph/documents/nbsb-mcmreport.pdf
National Commission on Children and Disasters 

Progress Report on Children and Disasters 

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7

HHS is making a purposeful effort to include pediatric experts on relevant committees and 

working groups addressing issues pertaining to medical countermeasures, including plans to 

organize a pediatric-specific MCM roundtable. In addition, HHS issued a Request for 

Information seeking laboratories that are adequate and available to develop new pediatric animal 

tests or models, or to update existing pediatric animal tests or models that meet FDA criteria, 

which may be useful to encourage the successful development of MCMs for children. 

3.2: Expand the medical capabilities of all federally funded response teams through the 

comprehensive integration of pediatric-specific training, guidance, exercises, supplies and 

personnel. 

HHS indicates the National Disaster Medical System (NDMS) implemented a Commission 

recommendation by hiring an Associate Chief Medical Officer with pediatric disaster medicine 

expertise. NDMS plans to enhance the number and depth of credentialed and trained pediatric 

specialists to supplement regular NDMS teams. NDMS reported it will also plan and develop 

core competencies and guidelines for a pediatric curriculum for NDMS response teams and 

initiate a cache development program to define a cache standard for pediatrics. The Commission 

finds that significant gaps remain and seeks a more fully-developed action plan from HHS 

by August 13, 2010, in order to report findings and recommendations to the President and 

Congress. 

HHS also indicated that the Office of Force Readiness and Development (OFRD) will begin to 

assign Pediatric Health Care Coordinators to each response team prior to June 1, 2010. However, 

there is no funding available in FY 2011 for OFRD pediatric teams or pediatric-specific field 

training or exercises. The Commission recommends that Congress appropriate funds to 

support these activities. 

At the request of HHS, and upon the Secretary of Defense approval, the DoD may provide 

support for the evacuation of patients and medical needs populations to locations where hospital 

care or outpatient services are available. The DoD provided patient transport during both 

Hurricane Katrina and the U.S. government response to the recent earthquake in Haiti. However, 

the DoD has indicated it has very limited capacity for evacuating and transporting pediatric 

patients because it does not have a mission requirement to incorporate pediatric response 

capabilities within its deployable teams, or to stockpile pediatric equipment and supplies for 

defense support of civil authorities or humanitarian missions. According to the Government 

Accountability Office (GAO),3

 DoD policy prohibits the agency from procuring or maintaining 

any supplies or equipment exclusively for the civil support mission, like disaster response, unless 

otherwise authorized by the Secretary of Defense. 

 

3

 Government Accountability Office. Homeland Defense: DOD Can Enhance Efforts to Identify Capabilities to 

Support Civil Authorities during Disasters. March 2010. Available from: http://www.gao.gov/cgi-bin/getrpt?GAO10-386
National Commission on Children and Disasters 

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8

The Commission urges HHS to address the gap within NDMS to safely evacuate and 

transport large numbers of pediatric patients in a large-scale disaster. In addition, if DoD 

continues to receive and respond to requests to provide civil support for disasters, DoD 

should be funded to plan, train and equip teams to properly evacuate civilian pediatric 

populations. 

3.3: Ensure that all health care professionals who may treat children during an emergency have 

adequate pediatric disaster clinical training specific to their role. 

ASPR hosted training sessions specific to children and disasters at a recent conference. However, 

it was not specified how many professionals received this particular training. In general, it is not 

clear how often and to what degree child-specific training is delivered to healthcare 

professionals, particularly federal disaster responders, who may treat children during an 

emergency. HHS has yet to establish core clinical competencies in pediatric disaster medicine. 

The Federal Education Training and Interagency Group for Public Health and Medical 

Preparedness and Response (FETIG) is an interagency group responsible for coordinating core 

competencies and education and training standards across federal departments and agencies, as 

well as state and local government entities, academia and the private sector in relation to public 

health emergency and disaster response. The Commission finds that significant gaps exist and 

strongly urges the White House to direct the FETIG partners and National Center for 

Disaster Medicine and Public Health to prioritize and address the significant gap that 

currently exists in providing pediatric disaster education and training, particularly for 

federal disaster responders. The FETIG may be a mechanism to establish a Pediatric Disaster 

Clinical Education and Training Working Group to establish core competencies and a standard, 

modular pediatric disaster health care curriculum, as recommended in the Interim Report, if 

adequate funding is provided from FETIG partners to the National Center for Disaster Medicine 

and Public Health. 

3.4: Provide funding for a formal regionalized pediatric system of care for disasters. 

In order to build upon the foundational role of children’s hospitals in strengthening and 

expanding a regionalized network for pediatric care, HHS is working with the National 

Association of Children’s Hospitals and Related Institutions to encourage membership in the 

NDMS hospital system as a means to enhance regional pediatric care capabilities during an 

emergency response. 

Through the American Recovery and Reinvestment Act (P.L. 111-5), HHS issued a Request for 

a Comparative Effectiveness Research Regionalization Demonstration Program, which will 

include pediatric care among its goals. In addition, the Patient Protection and Affordable Care 

Act (PL 111-148) includes a provision to authorize no fewer than four Competitive Grants for 

Regionalized Systems for Emergency Care Response, including a requirement that each 
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Progress Report on Children and Disasters 

May 11, 2010 

9

application addresses pediatric concerns related to integration, planning, preparedness and 

coordination of emergency medical services for infants, children and adolescents. Significant 

gaps remain; therefore, the Commission recommends that Congress appropriate FY 2011 

funds to support these projects. 

3.5: Ensure access to physical and mental health services for all children during recovery from 

disaster. 

The Commission is unable to report progress at this time, as the White House has not released 

the report to the President or the NDRF (expected June 1, 2010). The Commission will carefully 

review the documents and report findings and recommendations to the President and Congress. 

4.1: Improve the capability of Emergency Medical Services (EMS) to transport pediatric 

patients and provide comprehensive pre-hospital pediatric care during daily operations and 

disasters. 

The Commission recommended that a dedicated grant funding system be established to ensure 

that EMS are capable of managing children during times of a disaster. This will only be 

accomplished by providing a dedicated grant funding system analogous to the Aid to Firefighters 

Grant system currently administered by the U.S. Fire Administration. To date, this 

recommendation has not been acted upon. A significant gap is the lack of a lead federal 

entity to oversee EMS. An important first step for implementing the Commission’s 

recommendation is for Congress to authorize an entity to provide oversight and funding 

for this system. A dedicated EMS grant funding system is vital to the establishment of a 

regionalized pediatric care system; without a robust emergency medical service capability it will 

be difficult to move pediatric patients within the regionalized system. 

The Commission also recommended that additional funding be provided to the Emergency 

Medical Services for Children (EMSC) program to ensure all states and territories meet targets 

and achieve progress in the EMSC performance measures for grantees, and to support 

development of a research portfolio. The Patient Protection and Affordable Care Act (PL 111-

148) includes a provision to reauthorize the EMSC Program for five years, from FY 2010 

through FY 2014, and authorizes an appropriation of $25 million for the Program in FY 2010, 

increasing to about $30 million in FY 2014. 

For the current fiscal year (FY 2010), the Program is funded at $21.5 million, which is a $1.5 

million increase over the FY 2009 level. For FY 2011, the President’s budget, released in 

February, recommended level funding, or $21.5 million, for the Program. Continued work is 

needed to ensure that EMS vehicles carry pediatric equipment and hospitals are prepared for 

pediatric emergencies and have inter-facility transfer agreements and guidelines. The 

Commission recommends that the FY 2011 appropriation meet the full level of 

authorization at $25 million to meet these persistent gaps in everyday emergency medical 

preparedness for children. 
National Commission on Children and Disasters 

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May 11, 2010 

10

As noted in remarks for Interim Report Recommendation 3.4, the Patient Protection and 

Affordable Care Act (PL 111-148) includes an authorization for Competitive Grants for 

Regionalized Systems for Emergency Care, which includes a grant application requirement to 

address pediatric concerns related to emergency medical services. The Commission 

recommends that FY 2011 funds be appropriated to support these projects.

5.1: Establish a holistic federal disaster case management program with an emphasis on 

achieving tangible positive outcomes for all children and families within a Presidentiallydeclared disaster area. 

On December 1, 2009, the Administration for Children and Families (ACF) and FEMA signed a 

twelve month Interagency Agreement (IAA) to allow for the implementation of the ACF 

Disaster Human Services Case Management (DCM) Program. The IAA provides for the rapid 

deployment of disaster case management assistance to children and families and for the 

transition to a state-administered program to address long-term needs. 

For FY 2009, HHS requested, but Congress did not approve, $10 million primarily for the 

purpose of disaster human services case management capacity building (i.e. training and 

credentialing of personnel, planning assistance to states) and development of a comprehensive 

case management database for training and recovery planning. For FY 2010, Congress did 

approve $2 million. The President has requested $2 million in HHS’ FY 2011 budget. FEMA 

indicated that it does not have authority to support funding for pre-event training or direct 

services to families through a disaster case management program. 

Efforts are underway to list the DCM Program within the Catalog of Federal Domestic 

Assistance in time for the start of hurricane season, June 1, 2010. However, the Commission 

believes the federal government is inadequately prepared to build, support and deploy a 

disaster case management program with nationwide capacity. Congress must rectify these 

significant funding and authorization gaps. In addition, ACF and FEMA should be 

directed to pre-credential professional social workers and nurse case managers and 

provide them with specialized training in delivering the full range of needed services to 

promote recovery for children and families in the aftermath of a disaster. Furthermore, the 

Commission seeks clarity as to the determining factors by which ACF and FEMA will transition 

the program to a disaster-affected state, including contingency plans to continue the program if a 

state is unprepared to assume disaster case management responsibilities for its survivors. 

Within the domain of disaster case management, the Commission recommended FEMA conduct 

a review and modification of information sharing policies in times of disaster between FEMA 

and its federal and non-federal partners (including non-governmental organizations assisting 

children and families). FEMA published a new System of Records Notice that will improve 

FEMA’s ability to disclose information to certain government agencies and nonprofit 

organizations providing assistance to children and families. A series of informational DVDs is 

being produced to explain the process for requesting such information. However, FEMA 

generally only collects information it needs in order to determine eligibility for assistance and 
National Commission on Children and Disasters 

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May 11, 2010 

11

not broader information that would be useful in other recovery efforts. The Commission has 

requested FEMA collect information on children (i.e. ages, special needs) that can be useful to 

recovery partners beyond FEMA. 

6.1: Require disaster planning capabilities for child care providers. 

HHS does not have statutory authority under the Child Care and Development Block Grant Act 

to require state or territorial child care regulatory agencies or administrators to have disaster 

planning, training, exercising or coordination standards for child care licensure or registration. 

HHS and FEMA are collaborating to provide guidance and a template for developing statewide 

emergency preparedness and response plans for child care. However, there is no requirement that 

such plans be submitted as a condition of funding. The Commission urges Congress to address 

this gap and pass legislation requiring disaster planning in states as a condition of receiving 

funds through the Child Care and Development Block Grant program. 

In addition, the Commission notes that the Office of Head Start is developing regulations on 

emergency preparedness for its grantees. The Commission will report its findings in connection 

with this effort to the President and Congress. 

6.2: Improve capacity to provide child care services in the immediate aftermath of and recovery 

from a disaster.

HHS indicated that there are no funds available through the Child Care Development Fund 

program to provide additional resources to states for the purpose of supporting families impacted 

by a disaster or repairing damaged child care facilities. 

FEMA recently published guidance clarifying eligibility under the Stafford Act for 

reimbursement of (1) child care services during emergency sheltering operations and (2) facility 

damages incurred by government and non-profit child care centers. HHS will assist FEMA in 

disseminating the guidance to child care administrators in states and territories. FEMA also 

indicated the agency is revising its Public Assistance regulations to explicitly include child care 

centers as an essential service. FEMA previously indicated that the National Response 

Framework (NRF) will be updated and tentatively released for public comment and published in 

2011. FEMA has made a commitment to incorporate children’s needs into the NRF. 

FEMA noted that the Stafford Act does not allow for reimbursement of damages incurred by 

private, for-profit entities. However, the majority of child care providers are private entities with 

negligible profit margins. The ability to quickly rebuild child care and assist families in need 

is a significant gap that remains largely unaddressed. The Commission has recommended 

that Congress amend the Stafford Act, or alternatively create a contingency fund, to 

support child care services to displaced families, establish temporary disaster child care, 

and repair or rebuild child care facilities, regardless of their tax status.
National Commission on Children and Disasters 

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12

7.1: Establish a school disaster preparedness program and appropriate funds to the U.S. 

Department of Education (ED) for a dedicated and sustained funding stream to all state 

education agencies (SEAs). Funding should be used for state- and district-level disaster 

response planning, training, exercises and evaluation that are coordinated with state and local 

plans and activities. 

The President’s FY 2011 budget proposal includes $30 million for continuing the Readiness 

Emergency Management for Schools (REMS) program. REMS will provide discretionary, 

competitive grants to an estimated 150 school districts, with an average award of $253,000. 

REMS requires grantees to develop comprehensive emergency management plans, provide 

training for school personnel and coordinate efforts with state or local homeland security plans. 

ED estimates that since FY 2003 the REMS program has benefited nearly half of all public 

school students in the country. However, the Commission notes that REMS program funding 

reaches a small percentage of school districts nationwide and does not provide sustained, longterm funding for the districts it serves.4

 

ED is considering the recommendation and has committed to take the following actions: 

 July 2010: Conduct analysis of current REMS program to assess whether funds 

from the existing program could be used to support state education agency (SEA) 

activities and if so, in what form. 

 August 2010: Based upon outcome of analysis, develop a proposal for 

modifications to the REMS program to more actively incorporate SEAs, and 

secure approval for any needed changes. 

 January 2011: Administration forwards FY 2012 budget to Congress for 

consideration. FY 2012 budget request will reflect any approved 

recommendations regarding expanding or modifying the current REMS program 

to incorporate a more active role for SEAs. 

This plan of action is insufficient. Every school must have a comprehensive disaster plan in 

place. The Commission recommends new investments within the reauthorization of the 

Elementary and Secondary Education Act that build upon the REMS program to increase 

the capacity and flexibility of states to support and improve disaster planning for public 

and non-public schools. In addition, it is essential that all schools become better prepared 

for disasters; federal funding to support this goal remains a significant gap. 

 

4

 Since 2003, the REMS program has distributed 714 grants to 661 Local Education Agencies, serving a small 

proportion of the 14,200 public school districts nationwide. Readiness and Emergency Management for Schools 

Technical Assistance Center, “FY2009 REMS Grantees,” U.S. Department of Education, 

http://rems.ed.gov/index.cfm?event=grantees2009. 
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May 11, 2010 

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7.2: Enhance the ability of school personnel to support children who are traumatized, grieving 

or otherwise recovering from a disaster. 

ED noted that it does not have authority over teacher training or credential/licensing 

requirements. However, the Commission believes the reauthorization of the Elementary and 

Secondary Education Act provides an opportunity to encourage initiatives that support and 

promote training of teachers and other school staff in basic behavioral health skills to support 

grieving students and students in crisis. 

ED indicated it will continue to share and develop resources for educators to help support 

children who are grieving or traumatized. Specific action steps include: 

 July 2010: Provide a Bereavement and Loss presentation to FY 2009 REMS 

grantees as part of the Advanced Emergency Management for Schools training. 

 September 2010: Develop a Lessons Learned publication on suicide contagion 

and how to best support students after a suicide has occurred. In developing this 

publication, ED will utilize the expertise of SAMHSA and local education 

agencies that have experienced a suicide contagion to develop recommendations 

for educators. 

 Assess the feasibility of conducting a webinar on issues related to supporting 

children who have been traumatized, are grieving, or who are recovering from 

other disaster or crisis situations. The webinar would be open to a general 

education audience. 

The Commission believes these steps are worthwhile, but do not represent the actions 

necessary to implement the recommendation. The Commission will work with ED to 

develop opportunities that more fully support the desired outcomes. 

8.1: Provide guidance, technical assistance and model plans to assist state and local child 

welfare agencies in meeting current applicable disaster planning requirements and further 

require collaboration with state and local emergency management, courts and other key 

stakeholders. 

In 2006, in response to a GAO report5

 finding that only three states had comprehensive child 

welfare disaster plans addressing all vital components of disaster planning, Congress passed the 

Child and Family Services Improvement Act, adding a requirement that state child welfare 

agencies have minimal procedures in place to respond to a disaster “in accordance with criteria 

established by the Secretary” of HHS. Although the Children’s Bureau published an updated 

guidance document in 2007, no additional specific planning criteria was promulgated in 

 

5

 Government Accountability Office. Child Welfare: Federal Action Needed to Ensure States Have Plans to 

Safeguard Children in the Child Welfare System Displaced by Disasters. July 2006. Available from: 

http://www.gao.gov/new.items/d06944.pdf
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regulation by the Secretary. HHS reported that ACF regional office liaisons review the plans and 

can offer support to states in developing revisions or refer them to the Children’s Bureau 

Training and Technical Assistance Network. However, many states still have not engaged in 

meaningful and comprehensive planning efforts. The Commission has recommended the 

Children’s Bureau conduct an updated assessment of the current level of preparedness of 

state agencies across the country, strengthen enforcement of the Act and assist states in 

addressing planning deficiencies and developing more comprehensive plans. The 

Commission requests an action plan as to how the Children’s Bureau will address this 

recommendation. 

8.2: Conduct a national assessment of disaster planning and preparedness among state and local 

juvenile justice systems to inform the development of comprehensive disaster plans. 

In response to the Commission’s recommendation, the Office of Juvenile Justice and 

Delinquency Prevention (OJJDP) within the Department of Justice requested disaster plans from 

the state agencies that receive its formula funds. Fifteen grantees responded and it was found that 

the plans were predominantly intended for basic continuity of operations, rather than 

comprehensive disaster preparedness, response and recovery. 

The Commission also recommended that OJJDP form a working group with the mission of 

improving juvenile justice disaster preparedness nationwide. OJJDP has since established the 

Justice Working Group on Children and Disasters to create a document with guiding principles 

to assist juvenile justice facilities in developing disaster plans. The working group includes 

members from relevant federal, state and local agencies and non-governmental stakeholders with 

expertise in managing and providing services within juvenile justice systems, including courts, as 

well as members with disaster management experience. The document is scheduled to be 

released in January 2011. While the Commission supports these initial steps, OJJDP must 

identify effective mechanisms to encourage and fund disaster planning. In addition, the 

Commission recommends that Congress appropriate funds to support these activities. 

9.1: Provide a safe and secure mass care shelter environment for children, including appropriate 

access to essential services and supplies. 

The Commission finds significant progress towards the implementation of this 

recommendation. DHS/FEMA collaborated with the Commission in a multi-partner effort to 

develop two significant documents: (1) Standards and Indicators for Disaster Shelter Care for 

Children and (2) Supplies for Infants and Toddlers in Mass Care Shelters and Emergency 

Congregate Care Facilities. These documents are being incorporated into various shelter 

planning and assessment tools being developed by FEMA, HHS, American Red Cross and other 

federal and non-federal partners. FEMA is developing educational materials for parents and 

families to safeguard health and safety of children while staying in a shelter. FEMA has also 

updated and modified Pre-Scripted Mission Assignments to task ACF with conducting human 

services shelter assessments, which can help ensure the implementation of shelter standards and 

prompt corrective action to mitigate risks to children. While FEMA does not operate shelters, 
National Commission on Children and Disasters 

Progress Report on Children and Disasters 

May 11, 2010 

15

and reports that it does not have authority to establish or enforce shelter standards, it does 

provide guidance and reimbursement for eligible sheltering expenses under the Stafford Act. 

In response to the Commission’s concerns about accurately tracking child populations in 

shelters, FEMA’s National Shelter System will include a text field to capture a breakdown of 

children by age, which will improve the ability of shelters to support the needs of children and 

families. The age breakouts are anticipated to be included in all shelter guidance documents 

currently under development. 

10.1: Prioritize families with children for disaster housing assistance and expedited transition 

into permanent housing, especially families with children who have disabilities or other special 

health, mental health or educational needs. 

The Commission is working with FEMA and other federal agency members of the National 

Disaster Housing Task Force to identify and incorporate the essential needs of children and 

families into the Concept of Operations and Practitioners Guide. The document is due June 2010 

and will define the roles and responsibilities of federal and non-federal partners throughout the 

disaster housing continuum (sheltering, intermediate and permanent). The Commission will 

assess the document and report findings and recommendations to the President and Congress. 

11.1: Develop a standardized, interoperable national evacuee tracking and family reunification 

system that ensures the safety and well-being of children.

In response to the Commission’s concerns, FEMA has added an “unaccompanied minors” check 

box onto the paper-based and advanced technological versions of the National Mass Evacuation 

Tracking System (NMETS). When this box is populated on the electronic version of NMETS, a 

message will appear in red text indicating that the unaccompanied minor should be escorted to 

the proper authorities in compliance with state evacuation procedures. An additional text field 

has also been added to the electronic version of NMETS which allows for the input of 

information to describe an unaccompanied minor (i.e. eye and hair color, and other 

distinguishing attributes or information) and/or indicate the name of the agency or individual 

who has taken the minor into custody. NMETS is expected to be released to the states for 

implementation on June 1, 2010. FEMA is also exploring the development of an unaccompanied 

minors registry which would serve as a central repository for registering unaccompanied minors 

located during a disaster. This system would assist states to uniformly register unaccompanied 

minors, search data fields and reunite families more quickly. At the request of certain states, 

FEMA is working with private evacuee tracking vendors who hold state contracts in an attempt 

to develop a bridge for data exchange with NMETS, which is critically important for cross 

jurisdictional and interstate evacuations. 
National Commission on Children and Disasters 

Progress Report on Children and Disasters 

May 11, 2010 

16

Despite the progress in evacuee tracking and data sharing, a significant gap remains.

FEMA and Congress must provide the necessary funding to develop a national evacuee 

tracking system that seamlessly ties together federal and state systems, and also has the 

capability to interface with family reunification systems such as FEMA’s National 

Emergency Family Registry System (NEFRLS) and the National Center for Missing and 

Exploited Children’s National Emergency Child Locator Center (NECLC). Adults 

registering or searching for a displaced child under the age of 21 on NEFRLS are directed via 

Internet link to the NECLC. 
17

APPENDIX A:

 

Hon. Mark Shriver 

Chairperson 

Michael Anderson, M.D. 

Vice-Chairperson 

Ernest Allen, J.D. 

Merry Carlson 

Hon. Sheila Leslie 

Bruce Lockwood 

Gregg Lord 

Irwin Redlener, M.D. 

David Schonfeld, M.D. 

Lawrence Tan, J.D. 

Christopher Revere 

Executive Director 

NATIONAL COMMISSION ON CHILDREN AND DISASTERS

February XX, 2010 

Honorable [Name] 

Secretary 

U.S. Department [Agency] 

[Address] 

Dear Secretary [Name], 

In October 2009, the National Commission on Children and Disasters 

delivered an Interim Report to President Obama and Congress that includes 

legislative, regulatory, and administrative findings and recommendations 

addressing children’s needs as they relate to preparation for, response to, 

and recovery from major disasters and emergencies. The Commission is an 

independent and bipartisan body of ten members, appointed by the 

President and Congress. 

As a prelude to the Commission’s next report, which will be delivered to 

the President and Congress in October 2010, the Commission is preparing 

an ad-hoc report, to serve as an assessment of federal agency action toward 

full implementation of the Interim Report recommendations. 

On behalf of the Commission, I request your assistance in reporting to us 

actions taken and/or planned toward full implementation of the 

recommendations. We would also benefit greatly from knowing what 

barriers exist that precludes full implementation of the recommendations. 

The information is vital to guiding the future work of the Commission. 

Please have the agency complete the “[Agency] Status of NCCD 

Recommendations” document (attached separately) and return it via e-mail 

to Victoria Johnson, Policy Director, at: victoria.johnson@acf.hhs.gov by 

March 12, 2010. Any questions may be directed to Ms. Johnson via e-mail 

or by phone: (202) 205-9558. 

Thank you, in advance, for your assistance. We look forward to our 

continued collaboration to improve our nation’s disaster preparedness, 

response and recovery efforts for children and families. 

Warmly, 

Mark K. Shriver 

Chairperson
Please complete this document and return it via email by March 12, 2009 to Victoria Johnson at: 

victoria.johnson@acf.hhs.gov. 

There is no word limit, so please be as specific as possible. 

For reference, the Commission’s Interim Report can be downloaded at: 

www.childrenanddisasters.acf.hhs.gov. 

Department or Agency: 

 

Point of Contact (name/title/office/email/phone): 

Recommendation: 

[Insert here] 

Questions: 

1. Does the agency concur with the recommendation and its desired outcome? If not, how is the 

agency addressing (or does the agency plan to address) the gap underlying this recommendation? 

2. Current agency action to implement recommendation (please include a timetable for 

implementation, with specific steps taken to reach full implementation of recommendation): 

3. Results generated from implementation to date: 

4. Planned agency action to implement recommendation (please include a timetable for 

implementation with specific action steps planned to reach full implementation): 

5. Barriers, constraints or challenges to implementation of recommendation (federal law, 

regulatory, administrative policy, budgetary, other resources). For each barrier, constraint or 

challenge identified, please outline a plan to remedy or address: 
FOR MORE INFORMATION

Christopher J. Revere, Executive Director 

christopher.revere@acf.hhs.gov

202.205.9561 

Pamela Carter-Birken, Executive Deputy Director 

pamela.carter-birken@acf.hhs.gov

202.401.5124 

Victoria Johnson, Policy Director 

victoria.johnson@acf.hhs.gov

202.205.9558 

Randall Gnatt, Policy Specialist 

randall.gnatt@acf.hhs.gov

202.205.9559 

Frank Valliere, Policy Specialist 

frank.valliere@acf.hhs.gov

202.205.9540 

Jacqueline Haye, Executive Assistant 

jacqueline.haye@acf.hhs.gov

202.205.9560 

Roberta Lavin, Designated Federal Officer 

roberta.lavin@acf.hhs.gov

202.401.9306 

Website: www.childrenanddisasters.acf.hhs.gov

National Commission on Children and Disasters 

1250 Maryland Avenue, SW 

8th Floor East 

Washington, D.C. 20024