To receive FEMA assistance under FEMA’s Individuals and Households Program, through which disaster survivors can receive help with housing and other needs, individuals must register by answering a standard series of intake questions. In our May 2019 report, we found that some individuals with disabilities may have faced long wait times and unclear registration questions, and that FEMA’s internal communication across its programs about survivors’ disability-related needs was ineffective. Long wait times: Individuals who tried to apply for assistance using the helpline confronted long wait times, which may have posed greater challenges for those with disabilities. In the days after Hurricane Maria affected Puerto Rico and the U.S. Virgin Islands— when survivors from Harvey and Irma were concurrently contacting the helpline—up to 69 percent of calls went unanswered and the daily average wait time for answered calls peaked at almost an hour and a half, according to our analysis of FEMA data. While long wait times could be burdensome for all individuals, state officials and disability advocates we interviewed said long wait times were especially burdensome for people with certain disabilities, such as those with attention disorders or whose assistive technology prevents multi- tasking when waiting on hold. Unclear registration questions: FEMA’s registration process did not give individuals a clear opportunity to state they have a disability or request an accommodation because the registration did not directly ask registrants to provide this information. According to FEMA officials at the time, information about disability-related needs can help FEMA staff match individuals with disabilities with appropriate resources in a timely and efficient manner and target additional assistance, such as help with the application process. However, individuals with disabilities may not have requested accommodations or reported their disability and related needs during FEMA’s registration-intake due to the unclear questions. As a result, the registration process may have under-identified people with disabilities. For example, in Puerto Rico, an estimated 21.6 percent of people have disabilities, according to 2017 Census data. However, less than 3 percent of all registrants in the territory answered “yes” to the disability-related question in response to Hurricanes Irma and Maria. Ineffective communication across FEMA programs: Individuals may have faced challenges receiving necessary assistance because FEMA did not effectively track and communicate information about individuals’ disability-related needs across its assistance programs after such needs were identified. FEMA officials we interviewed for the May 2019 report explained that accommodation requests and disability-related information identified after registration-intake are recorded in a general “notes” section of a registrant’s case file, which can be easily overlooked as a case file is passed along to subsequent FEMA officials. In our May 2019 report we recommended that FEMA implement new registration-intake questions to improve FEMA’s ability to identify and address survivors’ disability-related needs. FEMA concurred with this recommendation, and officials reported that in May 2019 the agency updated the questions to directly ask individuals if they have a disability. According to FEMA’s analysis of applications for assistance following recent disasters, which used the updated questions, the percentage of registrants who reported having a disability increased. FEMA officials stated this increase gives them confidence the change has improved FEMA’s ability to identify and address disability-related needs of individuals affected by disasters. We also recommended that FEMA improve its communication of registrants’ disability-related information across FEMA programs, such as by developing an alert within survivor files that indicates an accommodation request. FEMA did not concur with this recommendation, explaining that the agency lacks specific funding to augment the legacy data systems that capture and communicate registration information. In its comments on our May 2019 report, FEMA stated that it began a long- term initiative in April 2017 to improve data management and exchange, and improve overall data quality and standardization. After FEMA completes this initiative, which officials said will be in 2024, FEMA expects that efforts to share and flag specific disability-related data will be much easier. We believe that in the interim, FEMA could explore other cost-effective ways to improve communication, such as through agency guidance that encourages program officials to review registrants’ case file notes. As FEMA moves ahead with its initiatives to improve data, we encourage it to consider and ultimately implement technology changes, such as developing an alert within files that indicates an accommodation request, to help improve communication across FEMA programs. State, territorial, and local governments are primarily responsible for response and recovery activities in their jurisdictions, including those involving health and safety. In our May 2019 report, we found that the substantial damage caused by the 2017 hurricanes prevented or slowed some individuals with disabilities from obtaining food and water. According to territorial and nonprofit officials in Puerto Rico and the U.S. Virgin Islands, as well as survivors we interviewed in the U.S. Virgin Islands, this was due to centralized distribution models, in which the majority of food and water was distributed to centralized locations around the islands. Officials from one governmental agency in Puerto Rico said this posed a major barrier to people with mobility challenges or without caregivers receiving food and water because they had to rely on home delivery, which took time and in some cases, did not happen. We also found that Hurricane Maria survivors faced challenges obtaining needed medication and oxygen in Puerto Rico and the U.S. Virgin Islands, according to territorial and nonprofit officials. State, territorial, and local agencies are also primarily responsible for administering shelters, when necessary, for those affected by a disaster. We found in our May 2019 report that individuals with disabilities affected by the 2017 hurricanes may have faced challenges accessing basic services from local shelters, including restrooms and food, according to state, territorial, local, and nonprofit officials in Florida, Puerto Rico, Texas, and the U.S. Virgin Islands. For example, nonprofit officials in Florida and Puerto Rico described instances of shelter residents with impairments that prevented them from accessing shelter restrooms. We also found that transportation was especially challenging for those who relied on public transportation or were unable to walk long distances, such as people with disabilities, according to state, territorial, local, and nonprofit officials we interviewed. For example, Florida state officials reported that few public transportation services, including paratransit, were functional following Hurricane Irma. This may have prevented some people with disabilities from maintaining their health and wellness—such as by shopping for groceries or going to medical appointments—after the storm, according to state officials. Officials we interviewed from Texas, Florida, and Puerto Rico for our May 2019 report said they had difficulty obtaining FEMA data that could help them deliver assistance to individuals, including those with disabilities. The officials explained that data—including names and addresses— showing who has registered for and received assistance from FEMA can help local governments and nonprofits identify who in their community needs assistance. To better facilitate authorized nonfederal partners obtaining these needed data, we recommended that FEMA develop and publicize guidance for partners who assist individuals with disabilities on how to request and work with FEMA staff to obtain the data, as appropriate. FEMA concurred with this recommendation and officials told us in July 2019 that the agency plans to publish data-sharing guidelines on its website, among other actions. Before initiating its new approach to disability integration, ODIC distributed an explanatory memorandum and other documentation to FEMA staff. For example, an April 2018 memorandum to FEMA Regional Administrators outlined a proposal to add new disability integration staff in each FEMA region to foster day-to-day relationships with state, territorial, and local emergency managers and disability partners. Also, ODIC distributed a document that described FEMA’s new approach to deployments. Under the new approach, fewer disability integration staff are to be deployed to disasters and all deployable staff and staff in programmatic offices are to receive training on disability issues during response and recovery deployments. However, in our May 2019 report, we found that these documents did not articulate objectives that could help the agency define success for the new approach. We concluded that without a set of common objectives for FEMA’s new disability integration approach, FEMA risks inconsistent application across its regions. In our report, we recommended that FEMA establish and disseminate a set of objectives for the new approach. FEMA concurred with this recommendation, and in July 2019 officials provided us with the draft of ODIC’s strategic plan for 2019-2022, which includes strategic goals and objectives that the new disability integration approach can help achieve. ODIC officials told us they will be working throughout 2019 with FEMA’s Office of External Affairs to disseminate the plan agency-wide and to nonfederal partners. We will continue to monitor FEMA’s progress toward sharing the objectives of its new approach to disability integration with critical stakeholders. To implement FEMA’s new deployment model, which will shift the responsibility of directly assisting individuals with disabilities from disability integration staff to all FEMA staff, FEMA planned to train all deployable staff and staff in programmatic offices on disability issues. We reported in May 2019 that FEMA officials emphasized the need to integrate disability competencies throughout FEMA’s programmatic offices and deployable staff. However, we found that the agency did not have written plans—including milestones, performance measures, or a plan for monitoring performance—for developing new comprehensive training for all staff. Starting in the 2018 hurricane season, FEMA had taken initial steps toward training some deployed staff on disability issues. For example, FEMA required all staff to complete a 30-minute training on basic disability integration principles and offered targeted “just-in-time” training to deployed staff. We concluded that developing a training plan would better position FEMA to provide training to all staff to help achieve FEMA’s intended goals. In our May 2019 report, we recommended that FEMA develop a plan for delivering training to FEMA staff that promotes competency in disability awareness. In its letter commenting on our May 2019 report, FEMA stated that ODIC is developing a plan to introduce the disability competency in FEMA’s position task books for all deployable staff. The letter explained further that ODIC’s plan will describe how FEMA will communicate the disability integration competency throughout the agency, establish milestones for measuring how effectively the competency is integrated across the agency, and outline how ODIC will monitor and measure integration of the competency across the deployable workforce. In July 2019, FEMA officials told us ODIC plans to hire new staff to focus on integrating the disability competency FEMA-wide. According to the officials, after the position task books are updated, ODIC will work with FEMA’s training components to ensure that disability-related training is consistent with the content of the position task books. FEMA officials also noted that the Field Operations Division, and not ODIC, is responsible for measuring how effectively the disability competency is integrated across FEMA. We will continue to monitor FEMA’s progress toward developing a plan for delivering training to promote competency in disability awareness among its staff. As noted in our May 2019 report, the plan for delivering such training should include milestones, performance measures, and how performance will be monitored. In our May 2019 report, we found that deploying a smaller number of disability integration staff and shifting them away from providing direct assistance to individuals with disabilities may result in nonfederal partners (such as state, territorial, and local emergency managers) providing more direct assistance to individuals with disabilities than they did previously. In February 2017, we reported that the comprehensive introductory training course on disability integration that FEMA offered to its nonfederal partners included substantial information on how to incorporate the needs of people with disabilities in emergency planning. However, according to officials, FEMA stopped offering this 2-day course in September 2017. ODIC officials told us during our 2019 review they had determined that the course, as designed, did not provide actionable training to emergency management partners to meet the needs of individuals with disabilities and planned to replace it. However, we found in May 2019 that although officials had plans to replace the course with new training, they had not provided a timeline, which would help ensure that partners are provided with timely information on inclusive emergency management practices. We recommended that FEMA develop a timeline for completing the replacement course and, in June 2019, FEMA officials said they had begun procuring external consulting services to redevelop it. According to the officials, ODIC had evaluated alternatives to the suspended course and determined that an in-person, exercise-based course with remote participation capabilities would be an appropriate replacement. FEMA officials said the course will take about 1 year to develop and will be ready to field by August 2020. In conclusion, FEMA has taken a number of steps toward addressing our recommendations related to how it supports individuals with disabilities in obtaining disaster assistance. ODIC’s draft strategic plan for 2019-2022, which articulates objectives for the new approach to disability integration, is likely to help facilitate consistent implementation agency-wide. In addition, we are hopeful that FEMA’s revised registration-intake questions, as well as data sharing guidance for nonfederal partners, will help FEMA and its partners better identify and assist registrants with disabilities. However, we continue to believe that implementing changes to disability integration before staff have been fully trained may leave FEMA staff ill-prepared to identify and address the challenges that individuals with disabilities face while recovering from disasters. We will continue to monitor FEMA’s actions as it makes additional progress toward addressing our recommendations. Chairman Payne, Ranking Member King, and Members of the Subcommittee, this completes my prepared statement. I would be pleased to respond to any questions that you may have at this time. If you or your staff have any questions about this testimony, please contact Elizabeth Curda, Director, Education, Workforce, and Income Security Issues at (202) 512-7215 or curdae@gao.gov. Contact points for our Offices of Congressional Relations and Public Affairs may be found on the last page of this statement. GAO staff who made key contributions to this testimony are Sara Schibanoff Kelly (Assistant Director), Sara Pelton (Analyst-in-Charge), and David Reed. This is a work of the U.S. government and is not subject to copyright protection in the United States. The published product may be reproduced and distributed in its entirety without further permission from GAO. However, because this work may contain copyrighted images or other material, permission from the copyright holder may be necessary if you wish to reproduce this material separately.

Summary: Three sequential hurricanes—Harvey, Irma, and Maria—affected more than 28 million people in 2017, according to FEMA. Hurricane survivors aged 65 and older and those with disabilities faced particular challenges evacuating to safe shelter, accessing medicine, and obtaining recovery assistance. In June 2018, FEMA began implementing a new approach to assist individuals with disabilities. This statement describes (1) reported challenges faced by these individuals in accessing disaster assistance from FEMA and its nonfederal partners following the 2017 hurricanes; and (2) the extent to which FEMA has implemented changes in how it supports these individuals. This statement is based on a May 2019 GAO report and selected updates. For the report, GAO analyzed FEMA documents and data from FEMA call centers and also visited 2017 hurricane locations to interview state, territorial, and local officials. GAO also interviewed FEMA officials from headquarters and deployed to each disaster location. To update FEMA's progress toward addressing its recommendations, GAO interviewed FEMA officials and analyzed agency documents. GAO's May 2019 report found that some individuals who are older or have disabilities may have faced challenges registering for and receiving assistance from the Federal Emergency Management Agency (FEMA) and its nonfederal partners (such as state, territorial, and local emergency managers). FEMA's registration did not include an initial question that directly asks individuals if they have a disability or if they would like to request an accommodation. GAO recommended that FEMA use new registration-intake questions to improve the agency's ability to identify and address individuals' disability-related needs. FEMA concurred and, in May 2019, updated the questions to directly ask individuals if they have a disability. GAO found that the substantial damage caused by the 2017 hurricanes prevented or slowed some individuals with disabilities from obtaining food, water, and other critical goods and services from states, territories, and localities. Officials from one state reported that few public transportation services, including paratransit, were functional following the 2017 hurricane affecting the state. The officials said this may have prevented people with disabilities from maintaining their health and wellness—such as by shopping for groceries or going to medical appointments—after the storm. GAO's May 2019 report also found that FEMA had taken limited steps to implement the agency's new approach to assist individuals with disabilities. GAO recommended the agency establish and disseminate objectives for implementing its new approach. FEMA concurred, and developed a draft strategic plan that includes strategic goals and objectives for the new approach, which the agency plans to finalize and disseminate in 2019. GAO recommended that FEMA, as part of its new approach, develop a plan for delivering training to all FEMA staff deployed during disasters that promotes competency in disability awareness. In concurring with this recommendation, FEMA described its plan to incorporate a disability awareness competency into the job requirements for all deployable staff, but has not yet developed a plan for training. GAO's May 2019 report also recommended that FEMA develop a timeline for completing the development of training on incorporating the needs of individuals with disabilities into emergency planning, which it planned to offer to its nonfederal partners. FEMA concurred with GAO's recommendation and, in June 2019, officials began procuring external consulting services to develop a replacement course. According to officials, the course will take about 1 year to develop and will be ready to field by August 2020. In the May 2019 report, GAO made seven recommendations to FEMA; FEMA concurred with six. FEMA has established new registration questions and a timeline to offer training to its partners. GAO continues to believe its recommendations to develop a plan to train its staff on disability awareness, among other actions, are valid.