Integrar la salud, la salud conductual y la seguridad en las emergencias

(En inglés)

Integrating Health, Behavioral Health, and Safety in Emergencies

Nancy Topping-Tailby: Let's get started. I'm really pleased today that I have this opportunity to present with three of my colleagues, including the National Center Co-Project director Neal Horen, and our colleagues Mercedes Gutierrez and Maria Eugenia Vazquez Betancourt. We'll introduce ourselves, and then Neal's going to start us out. I'm going to turn it over to Neal.

Neal Horen: Thanks, Nancy. Welcome, everyone. Super excited to be with you. I'm Neal Horen, and I am the co-director of the Center with Nancy. I will pass it over to Maria Eugenia. I'll quickly pass it over to Maria Eugenia.

Maria Eugenia Vazquez Betancourt: Can you hear me now?

Neal: Yeah, you're good.

Maria Eugenia: Good afternoon, all. My name is Maria Eugenia Vasquez Betancourt. I'm part of the National Center on Health, Behavioral Health, and Safety as a training technical assistant specialist. Mercedes.

Mercedes Gutierrez: Hi, everyone. My name is Mercedes Gutierrez, I am a senior training and technical assistance associate with the National Center for Health, Behavioral Health, and Safety. Happy to be here today.

Neal: Awesome. I will get us started. We will start with some objectives. We always like to say, this is what we're going to do. You hold us to it. Make sure that we talk about this. We'll check in at the end. If there's something we didn't get to throughout, just be putting that in the Q&A. We do want to start by talking about the three phases of the emergency preparedness cycle.

We're going to spend much of our time, and this is just a reminder that all of us at the National Centers are working collaboratively, all of the National Centers, to put on a series of webinars. This is the second in that series. We're going to probably focus mostly on preparedness today. It's one hour. We couldn't possibly cover everything, but we will at least describe those three phases today.

We'll talk really the gist of what we're trying to do, is talk about strategies for all of you to start to think about how you put all of this together in that work, health, behavioral health, and safety. We always come at our work from a trauma-informed approach. Again, in one hour, we're not going to do a lot of definitional pieces but know that that's the way we really promote folks, thinking about in their disaster planning response and recovery taking that kind of an approach. We're going to identify some resources to help you with the development of that plan. That's what we're trying to do today quickly. We're going to keep it moving.

On this next slide, we do the underpinnings of all of this are around social determinants of health. If you're not familiar with that, you're in luck because our centers designed this wonderful infographic for you, and they really are the conditions, as you can see here, in which people are born, live, learn, work, play, worship, and age. Why is that important? Because that is really about the range of risk factors, quality of life, outcome factors. We know that 80% —research tells us that about 80% of health outcomes are really driven by these social determinants of health.

We're going to come back to this a bit throughout, but just keep in mind, and I'll show you here in a second, why we think this is so important in terms of the work that you all are doing. It's really the foundational aspect of our overall center. Really, we sort of in all the work that we do, we think this is a critical way to examine that work, and in particular around emergency preparedness response and recovery. I'll come to that here in a second.

Just a reminder, we want to talk about — there is a program performance standard. If I were probably Steve Schuman, I could memorize the number off the top of my head, but it's right here for you anyway. Just a reminder that all Head Start programs are required to have a disaster preparedness plan. Those disasters, emergencies come in lots of different forms. 

Sometimes we are paying attention to the big, natural disasters that are in the news and that have impacted many of you that we forget that there's lots of other ways. Those things like hurricanes that are naturally occurring are easy to keep in mind, but there are lots of other emergencies that we want folks to be thinking about, acts of violence that are caused by people, can be very unexpected. We really want you in your planning to be thinking about these. That's part of that safety piece. 

We use those terms disasters and emergencies interchangeably because we want you to be prepared for any of the kinds of things that may come up for all of you. Keep in mind that you are required to have a disaster preparedness plan. We're required as a National Center to help all of you with the development of the thinking that goes into that plan. Our National Centers are here to support the field, that's all of you. We really want to spend some time today talking about that. 

I'm going to come back to something that I mentioned a couple of minutes ago around social determinants of health. This is a little bit busy of a graphic. When you have a chance to look at the materials that we provide you, take another look, but it's really important to understand that in some communities, disparities have a huge role in terms of emergency preparedness, planning, and response. 

Why? We know that Black, Indigenous, and people of color in the United States are disproportionately affected by disasters. That stems from decades of historical and systemic disinvestment and discrimination in communities of color. How does that sort of turn up? We talk a lot about preparedness. Well, how might that impact folks who are living paycheck to paycheck? How might that impact folks who live in disaster-prone areas? We've learned this over time. 

Even if everybody could do everything they wanted, sometimes response resources are significantly delayed for the most vulnerable communities. Think about in Puerto Rico. Eight days post-disaster, weeks after, there were still communities that lacked safe drinking water, basic food supplies, transportation, electricity. 

What we want folks to be keeping in mind is not just, I have to develop a plan, but what is the plan that I'm developing, for whom, where? That social determinants of health, these issues around how disparities are impacted, is really important for folks is really important for folks to keep in mind. We're going to keep moving because if I don't hit the 8-minute mark, I know somebody's going to yell at me. I'm going to do my best. Just joking. We like to think about emergency preparedness as a process, taking steps to ensure your program is safe before, during, and after an emergency. 

Part of that is assessing the environmental risk factors that might impact the safety of your facilities, making sure you have the resources that your staff need to access in the event of an emergency or disaster. When you're preparing, we want you to start to think about who are you working with. When you work with young children and their families, how do we respond quickly and appropriately, developmentally appropriately also, to protect the health and safety of the children and the adults who care for them?

Preparedness takes place before an emergency. That's being informed about any likely emergencies in your area. Some of these are predictable. I live in Florida, but for some reason I decided I would spend the day in DC today where it's like 12 degrees. In Florida, we have hurricanes. I need to be prepared. Being informed about likely emergencies in your area is really important part of preparedness. 

Making plans to respond to emergencies before they happen really helps to lessen any of those concerns that could get worsen if there were an emergency or disaster. That's preparedness. Response. That begins the moment that you're alerted to an impending emergency and continues throughout the emergency. As soon as you know that there may be, again, natural disasters, sometimes those are sort of we know ahead of time. With some emergencies, we don't. It begins the moment you learn about it and goes throughout the emergency. 

Then recovery. That starts as soon as the emergency is over. When those efforts are focused on food, water, shelter, safety, and, from our perspective just as important, the emotional needs of those who've been impacted. Recovery continues throughout the process of rebuilding your program if that's necessary, resuming your routines after an emergency. That can last for hours, weeks, months, even years in very extreme cases. 

We'll be able to do lots of other webinars as we move forward. Our National Centers, our collaborative teams to talk about some of these other aspects. We're going to spend most of our time today talking about preparedness. To do that, we want to pull up a little poll here for you. Kate, if we can pull that up. Which activities has your early childhood program done to prepare for disasters? You can have as many answers as you'd like. You don't have to just pick one. You can pick more than one. We'll give you just a little bit here to respond. 

See lots of folks responding. I know Nancy is very excited with the numbers. I'm super excited just because it's moving really fast and hundreds of people are responding. It's awesome. I see a lot of folks have scheduled fire drills. I see a good amount of you, and we'll post the results for folks in a second here. A lot of folks have relocation sites, have updated child and family emergency contact info. Let's go ahead and close that poll, Kate, if you don't mind, please. If we can show those results. 

It looks like — I'm not sure if everybody's seeing those results or not. There we go. Lots of folks have done lots of great work here. We're going to turn this over I'm going to turn this over to Mercedes and we'll talk a bit here. 94% scheduled fire drills, 87% updated contact information, and some folks who have a lot to learn. That's great. Mercedes, I'm going to turn it over to you and we can start talking about some of the real key activities in preparedness. 

Mercedes: Thanks, Neal, and thank you all for completing the poll. It gives us an idea of what you're here to learn today. We appreciate you filling that out. It seems like a lot of you have some things in place. Over the next couple of slides, what I'm going to do is take you through a few simple steps that you can do to start to get your emergency preparedness plan in place. 

Step one, we would like you to form an emergency preparedness task force. Consider forming this task force to gather the information that you'll need to begin to write your disaster preparedness plan. When you think about your task force, think about having a diverse group of people on this team. You can have staff members, family members, community members. 

Definitely think about having mental health professionals, public health professionals, emergency service workers, people within the community that understand the risks and the hazards of the community. Also, consider having representatives from your local school district or your local emergency management office. They may have some systems in place that can help your programs during an emergency response. 

The next slide is just to give you an idea of once you form this task force and you form this diverse team, here are some things that you should be talking about with your team. You should be utilizing them to help you identify the common hazards in your local area. You should talk to them about what are some emergency management systems that are already in place that maybe you can sign up for, some alert systems that parents can sign up for on their phones and that programs can sign up for as well. 

Use them to discuss local community-preparedness activities that you can take part in and also some resources that might be available that you're just not aware of. Make sure that you invite people from your program and within the community so that you are really representing diverse roles and perspectives and that you're really learning from the task force. 

When you build your task force, you should also think about considering special subcommittees that specialize in certain areas. For instance, our partners at PMFO did the first webinar in this series and talked about having a specific subcommittee for facilities. On that subcommittee, you would have engineers. You would have people that really understand how to prepare your building for emergency and for a disaster, and how to respond quickly. Think about the need of your program, the need of your area, and where you can build those specialized subcommittees to help you prepare your emergency plan. 

Step two, we want you to consider doing a disaster preparedness self-assessment. On this slide, you'll see a link and a QR code, and that takes you to this resource that we wanted to share with you. Like the poll showed, you all are doing some really great stuff already. I know a lot of you have fire drills in place and a lot of you have updated your emergency contact information. 

This is a very comprehensive self-assessment that helps you understand what are your strengths and what are some areas that you still need to work on? As you go through this worksheet, you will be able to prioritize your preparedness activities and identify some areas where you need to do a little bit more digging and learn a little bit more. This is a great foundation to bring back to your emergency task force and say, “OK, now we know where we stand. What can we do now to form an action plan and make improvements to strengthen our program's preparedness?”

Some of the questions that you might see on this assessment are, has your program done a self-assessment? Or have they talked to have you talked to a local emergency management office? Do your does the staff know their roles and responsibilities when they are faced with a disaster situation? These are a great list of questions just to help you get started and help you start that foundation of your emergency preparedness plan. 

The next step we want to walk you through is identifying the disasters and vulnerabilities in your community. Your task force needs to consider what emergencies and disasters will be covered in your plan. It's very important to go through all of the types of emergencies. Like my colleague Neal mentioned, it's not just the natural disasters that we're preparing for. There could be other things that we want to consider and develop a comprehensive procedure for all of those possible disasters and emergencies. 

Once you know the risk in your community, you're able to prepare for the most common kinds of crises or disasters that may impact your program. It's important that you contact your local emergency management agency and discuss with them what is happening, what are they seeing frequently, and how do they suggest that you respond in certain situations? 

It's also a good idea to find out about other hazards. Apart from these natural disasters, there could be local power plants or factories that could also cause some sort of natural or some sort of disaster or emergency that could impact the children and families within your program. Doing a little bit of digging and doing a little bit more research is a very important step in your emergency preparedness planning. 

On this slide, there is another QR code and link. This link takes you through a checklist of all of the possible types of disasters and emergencies that could happen. It's good to go through all of them. You might not be thinking about certain disasters or emergencies, and you might just be familiar with your area. It's important to go through this checklist with your task force and with everyone at the table so that you can discuss how to prepare for your program, for your children, and families. 

The next step that we wanted to discuss is getting your facility ready. You can use the Facility Hazard Risk Assessment in the Natural Disasters and Head Start Facilities Interactive Guide that was developed by our colleagues at PMFO to identify facility issues that may affect their ability to withstand a natural disaster. 

If you were on the first webinar, you saw that they gave a very comprehensive approach to determining if your facility was ready. On the next slide, I want to show you some really great resources that PMFO also shared with us that are now available to you all on ECLKC, which are building risk assessments. These building risk assessments help you determine how ready your building is for certain natural disasters. 

Once you gather all of these building risk assessments and complete them all with your task force, you would be able to do a comprehensive risk assessment and develop a plan to address and prepare your facility for these natural disasters and resources natural disasters and emergencies. I wanted to point you to another QR code that is on this slide. There is also a link here that takes you directly to this interactive guide on ECLKC. I'm going to pass it over to Nancy. 

Nancy: Thank you, Mercedes. Let me know if my sound is not working well. Some folks said I was a little soft before. I'm trying to speak a little louder. Step five is getting your supplies ready. We have two resources that we're going to show you in just a moment. If you could, would a few of you put in the chat what supplies do you think you need to have ready for an emergency?

Let's see what people have to say. Somebody says water. Definitely need water. Baby supplies, first aid, food, batteries, radios, medication, blankets. Absolutely. Diapers. Yes. You wouldn't want to get stuck without diapers if you're serving infants and toddlers. That's for sure. Formula. You all have many ideas. I'm going to move to the next slide, please. Here are two things that we at the National Center on Health, Behavioral Health, and Safety think are very important for you to have. One is that Maria will talk about in a moment, the Bee CALM Backpack. A lot of what I'm going to talk about is related to what's in your go-bag, and that's what I was just asking you about. 

Here are some things that we think are very important. Children's emergency contact information. That would be contact information that's up to date, attendance sheets that you know if you have to move to shelter in place. Then eventually, if you have to relocate to another facility that you know that you have everybody that you're supposed to have. You need to know where to go. You need to have first aid and hygiene supplies if you're serving younger kids, infants, and toddlers. Medication and care plans, especially for children with special healthcare needs, need to be ready to go so that you would have enough medication, and understand what you need to do if you're having to care for children for a while who are not going to be able to reunite with families. 

There's a whole host of things. We have a link for you on this slide for how to build an emergency kit that we hope has been helpful to you and that you can check out for more information. Everyone, we think, should have a ready-to-go bag that is going to be available so that if you have to go, you can go quickly and you know ahead of time, here's our preparedness focus, that you have what you need. Next slide, please. 

We're going to give you just a moment to put some ideas in the chat. How will your account for children's individual healthcare needs? If you have children who have healthcare needs, as I'm sure all of you do, what special considerations might you think about for those children? How about we look on the chat? Healthcare plans. Action plans with medication. Absolutely. Asthma action plans. Have a binder, somebody said, with special considerations. EpiPens. Snacks. Definitely need snacks. Mercedes, can you click forward? 

Here is a wonderful resource that was developed by some of our partners at The California Child Care Health Program at the University of California, San Francisco that is a kind of a quick reminder that you can use as an emergency checklist for children who have special healthcare needs that you have what you need, especially I want to call attention to the evacuation and transfer if you have non-ambulatory children. We hope that this resource will be helpful for you as well. Next slide, please. I'm going to turn it over to Maria Eugenia. 

Maria Eugenia: Thank you, Nancy. As a mental health reminder, it is important to remember that when preparing for disaster, it is common for people to feel anxious and past traumas were reserved. That's why we think about all these things that we may need to put in our backpacks as you are answering to Nancy before. 

It's also important to take into consideration the social and emotional well-being of both children and adults during the emergency planning process. This can be achieved by involving an infant and early childhood mental health consultant in your task force. The task force that Mercedes was talking about, that diverse team that you need to integrate in your planning process, that infant early childhood mental health consultant can help address the mental health concerns and alleviate anxiety that may arise during the planning process. 

By working with your infant early childhood mental health consultant, your emergency preparedness planning process can comprehensively and proactively address children's and adults' social-emotional well-being. This approach ensures that everyone's concerns are considered, making the planning process effective and also safe. Remember that relationship building is the most critical area of focus in preparedness. 

Without a pre-established relationship, no work can continue. We all know this. The relationship and support will make you feel prepared and confident that the work that you are doing really reflects the distinct needs of those we serve. Next slide, please. What is important why is it important to be prepared emotionally for disasters or emergencies? Experiencing a traumatic event can lead to various losses, which may create a sense of uncertainty in the unknown, anxiety about the future. Your surroundings may have undergone significant changes, which can make it more difficult to adjust for children and even for adults. 

Preparing yourself emotionally for a disaster or emergency can help you manage stress and anxiety. Learning to cope with stress in your daily life can better equip you to deal with challenging situations. Additionally, being emotionally prepared also help you recover from trauma more quickly and with fewer long-term effects. That's what we're looking for here, how to just provide and create some strategies these traumatic or adverse experiences for children and adults can take fewer longer-term effects. Next slide, please. Thank you. 

When dealing with traumatized children or adults, it is important to shift the thinking from, “What is wrong with this child?” to, “What happened to this child that may impact their current behavior?” This is right here, the part of being trauma-informed. By understanding their experiences, the children experiences, their history, we can help them recover from trauma more effectively. We need to start switching ourselves and we need to ask ourselves, what can we do? How can we help to provide them with the needed support? Next slide 

Thinking about the ways to support and provide strategies that can help children and adults prepare emotionally and ways to help reduce the effects of trauma, the National Center on Health, Behavioral Health, and Safety has created this prototype, this backpack prototype that we call it the Bee CALM backpack. CALM stands for calming and learning materials. We encourage programs to create their own backpacks. 

[Inaudible] can be used for group facilitation, like for those field trips to the park and so on. Also, another one for home visitors. Home visitors can have this own Bee CALM backpack so they can go to home to family's houses and share all these strategies with them as well. You can find all the list of those resources that we are sharing featured here in this slide. Scanning the QR code and also by using the link that has been written below on the slide. 

Let's talk about what's in the backpack and how to use it. All these resources that we're suggesting here, we're suggesting it because there are multiple languages. They are free of charge. Even some of them are from our consortium partners, from consortium partners from the National Center. I'm going to mention some of them, like Sesame Street in Communities, National Center of Pyramid Model, Inc, and the Center for Early Childhood Mental Health Consultation. 

We encourage you to use these products that we're featuring here on any way or I'm sorry, or any other product that you're already using in a classroom on a daily basis to help children. For instance, what do you use for help children transition from one activity to another one? Whatever you use with children in classroom to identify their emotions, face emotion faces, those signs that you may have in the classroom to manage for children to manage strong emotions that you can put at smaller size. You can put it in protective sheets, clear paper, and put it in your backpack. 

For instance, it can be a story that you're telling the children during story time. You can make a duplicate of that story or that book and you can put it right there in your backpack to have it ready for whenever situation and here is an emergency occurs. It can be even an extra stuffed animal that you use in a classroom or a puppet that you use. This way, children become familiar with these resources. During the natural emergency, you and the children may remember how to respond or how to 

For instance, if you're working with counting exercises as a breathing exercises for Tucker the Turtle, you can have a copy of those. You can have a copy of a script of how to help children calm. That may work also for yourself as an adult as well. Am I talking too fast? Let me check here if I have any messages from my colleagues. I'm good. Let's continue. 

Think all comfort you can provide for your children in the moment of advert in the moment of emergency that can help them increase the sense of safety. This is not only just to breathe in, breathe out, calm because also when you're just trying to be passive waiting for somebody to unlock the door for you after the emergency, some children maybe want to be active. 

Consider maybe to integrate like a soft tiny ball or a stress ball you can play around. Consider to include in your backpack coloring pages, crayons, things that you already are using in the classroom so you can just incorporate there in your backpacks children can continue to be active in shelter in place or if you need to move or stay in the indoors for several hours in a small space. You have many things to entertain and calm children through all these process of just being maybe sometimes just wait to be rescued. 

Another way to provide comfort to children is how you can be familiar to them. Some programs I have heard that they created like a family album so they can have pictures of the families. Also, some people may have some product that you're using in the classroom so they're familiar with it. You're giving them a sense of control, a sense of normalcy even though they're just in shelter in place. 

Last, but not least, the calming and relaxing exercises, as I mentioned before. The part of all these techniques of a relaxing technique, sometimes when something happened when you're in the middle of an emergency, you may just black out. You may just forget everything, forget all the strategies that you know for sure. You have here a script. You have here like a guide for yourself to help yourself and children. Next slide, please. 

It also helps create an emotionally safe environment for children. Let's think about being involved in a serious accident or a violent crime, natural disaster as we've been mentioning far. This can be overwhelmingly stressful for children and even for adults as well. Even a tornado wash warning, we can just get really stressed out. Disaster, crisis, or another troubling event can bring a sense of uncertainty. You need to think how we can manage this big emotion of [Inaudible], sadness, fear, and perhaps even anger sometimes. 

Children also may raise questions rise questions and emotions of the sense of security and leave them feeling with all these experiences, the children may be feeling helpless or vulnerable, especially if the event in from an act of violence like a shooting. We suggest to recognize that every child is different, is individual. They have their own experiences. They have their own story in their communities, their own history. 

Keep conversations open with caregivers. Keep conversations open with children. Of course, it's conversations. Please keep them appropriate for their age and developmental stage. Young children need brief simple information to be balanced with reassurance. Includes information that program is safe, that the program will close their doors in case of emergency as we close our doors at home at night. 

Think of children often gauge how threatening or serious the event is by the adults' reaction. I have a quick example to give you here. My mom had a small car accident with my daughter. My mom started screaming at the moment and crying because of the safety of my daughter sitting in the back seat. My daughter never forgotten that stressful experience. 

Then one day somebody just bumped into my car and my daughter immediately jumped and screamed, “Mom, are we OK?” I said, “Yes. Yes. It was just a bump. We need to wait for the police.” We did the police report and so on. On our way back, me driving my car it wasn't that bad my daughter had said to me, “Wow, Mom. I remember when I had that car crash with nana. Was so nervous because of my safety that at the end she made me feel more nervous and more anxious as she was.” 

This is an example of well, my daughter was able to verbalize and identify those emotions. This is how children respond by seeing adult how we respond to an emergency situation. Or even the same situation that we encourage parents in the drop off. In the fourth day of school, we encourage them to be calm during the first day of drop off to reassure children that everything will be that mom or dad or nana will be picking them up at the end of the day. 

Why? Because we want them to make sure that they feel safe, that we can help them reduce their level of anxiety. Reassure children about their own safety and security. Help children play and talk through their feelings understanding. Make sure that children feel safe to express their feelings. It's to cry. It's to feel scared. Reassure those emotions. Make sure that children knows that everyone in the center, in the program cares about them and is there to support them. 

Also, consider it's really important to consider create a space that reflects the children's cultural diversity. It's imperative to practically develop strategies for effectively communicating with children or caregivers that have diverse cultural and linguistic backgrounds. Next slide, please. Let's fast-forward this. Mercedes.

Mercedes: Thank you, Maria. Thank you for that comprehensive explanation. I want to bring it back to where we started, which was the Head Start program performance standard that says all programs should have a disaster preparedness plan. If you see, we've taken you on a journey here. We've gone through steps to hopefully break it down and make it a little bit more simple for you. Then finally, I want to give you this cheat sheet, if you will. This tells you all of the components that should be included in your disaster preparedness plan. 

Once you have your task force in place, you've gone through all of those possible hazards, you've discussed disasters and emergencies that are likely to occur in your area, you've talked about how ready your facility is, you've assessed the safety of your facility and talked to and put an action plan in place to make improvements, you've gathered those emergency supplies, whether it be that Bee CALM backpack or go bag, both of them hopefully, you should be ready to write your disaster preparedness plan. 

As you write this plan, we want you to consider the actions that you're going to take before. We've talked a lot about preparedness. We want you to write the actions that will happen during an emergency and disaster. Then that after is that recovery phase. Sometimes the recovery, as my colleague Neal mentioned, can last for a while, but have to understand all of the steps that need to take place during all of those phases. Before, during, and after is that comprehensive cycle of EPR&R. 

We've given you a lot of resources: forms, templates, and worksheets that you can use to help build this emergency disaster preparedness plan. Make sure that you're considering all of the age groups within your program. Make sure that you're considering the group setting. I saw we had some questions about home visiting or center based. Make sure all of that is included when you are writing your emergency preparedness plan. 

As you go to as you develop this plan, it's important to next identify the identify and assign the emergency roles and responsibilities. You'll see that this is a comprehensive list of everyone's roles that could possibly be during this emergency. I know there's a lot of roles listed here. I want you to consider giving one person more than one role. It might be that the incident leader could be the program director, but that the incident leader could also be the communications lead. Whatever makes the most sense for your program. 

As you reflect back to the previous slide, you'll see that there's a lead for all of those areas and all of those components within your disaster preparedness plan. You need somebody to understand their complete role within the plan. We suggest that you sit down, and have it sit down with them during a meeting and have it all written out. If someone is the incident leader, they should know every role, responsibility, task, everything that they have to do as that leader. That goes to be said for all of these roles and responsibilities listed here. 

I know my colleague Nancy will go over some of the resources that we have for you, but as we go to update our emergency preparedness manual, you will be able to get this list of emergency roles and responsibilities, and it will show you it will give you an idea of some of the tasks that should be assigned to each of these individuals within your team. 

Another step of building your emergency preparedness plan and also just preparing your program is to do drills. you were getting we're helping you get ready, but we want you to stay ready. Many of you are already doing fire drills. That is wonderful. We also want you to consider some of the other emergencies and disasters that could impact your program and do drills and practice for them as well. 

My colleague Nancy mentioned that you could have children with special healthcare needs within your program. It is so important to when you're doing these drills that you practice all of the things that you would need to meet the needs of these children as well. drills should include, not just the adults. You're not doing them at a time when it's just adults in the building. You want the children to be aware of their role in these drills as well. 

You want them to be able to know what to expect. Like my colleague Maria mentioned, once they get used to this practice, practice, practice, it becomes less traumatic for them. They know what to expect. They know how to go through this process. It becomes easier for everyone involved, both the children and the adults in the program. Just checking time. 

I want to before we go into resources, we just wanted to see if we could reflect on some of the things that we learned today. In the chat box, I want you to write your responses to this scenario. I'll read it out loud. The local news is reporting an approaching blizzard. The storm is still two days away, but it is making its way toward your community. Your program has two preschool classrooms and five infant and toddler classrooms. You want the staff, children, and their families to be as safe as possible. What steps would you take to implement your disaster preparedness plan? 

In the chat box, if you can, reflect on what are some things that you would do to get your program ready, to get your plan to get your family and staff ready. I see, make sure they know the inclement weather plan. That is great. Review the emergency plan with staff and parents. Remind parents to check websites for updates and delays or closing. Have a phone tree ready. Let parents know the school may close. All of these are so great. That's exactly that's exactly what we wanted you to respond. 

You know you have two days in advance, so you know it's coming. This is a good time to sharpen up on all of those communication tools that you have in place, whether it's the phone tree, whether it's posting a note on the door for those that come. All of these things need to be put in place beforehand. You're lucky with this scenario to have that two-day notice to get ready and to make sure that you can sharpen up some of the tools that you have in your preparedness plan. Inform families where to find emergency info. Love it. Thank you. 

I'm going to move to the next slide. These are just questions that we want you to take back to your team. You don't have to answer them in the chat. As you listen today, something may have jumped out to you, something may have made you think a little bit more about the emergency plan that you have in place or don't have in place and that you need to start writing. Here are some reflections for your team. 

What do we need in our EPR, in our manual to have an EPR&R plan in place that integrates health, behavioral health, and safety? Whom do we need at our table to make our plan? That's just a reminder of that task force that we talked about much, who should be included in that. What do we need to change? What is not working? What else do we need to explore or add to our plan? I'm going to hand it over to Nancy for some resources for you all.

Nancy: Thank you, Mercedes. I've been busily answering questions in the Q&A pod, and I haven't answered the last question. When you go to the next slide and you go to the next slide, there was a question about are there new emergency preparedness manuals available for people who would like to download or print them? This is the current manual and it's got great information. Most of the information that we've shared today is addressed in some form in this manual. 

We're also giving you a preview of some new information because we are currently in the process, and we're very close, to well, we're relatively close, I'll say, to releasing an updated emergency preparedness manual. Watch for ECLKC. We will do an e-blast when it's available, but there are really great resources on the ECLKC. If you can't find what you need, then please write to us at health@ecetta.info. The manual that is there on the ECLKC and available at this URL is a great resource. Next slide, please. 

We want to just say to everybody practice, practice, practice. The time to practice is not during an emergency. In order to be prepared, people really need to know what they need to know how to do when there is an actual disaster or emergency. You can find these practice scenarios in the materials that are available on the ECLKC. It was exciting to see that many of you do have practice drills, and we hope that you practice for all of the types of emergencies that you are most likely to encounter in your program. Next slide, please. 

Cold weather safety seems like a timely topic. We had a scenario about cold weather. just to know, here is our resource on cold weather safety. We also have plenty of resources for you on what to do during hot weather too as we have had more extremes in both our hot and cold weather with many of the changes in our climate. Next slide, please. 

We had an opportunity to develop this Health and Safety Recovery Checklist after the Hurricanes in Puerto Rico. Along with the resources that are available in the PMFO guide that Mercedes referenced, this is a very, we think, useful health and safety recovery checklist that is available in both English and in Spanish that you can use to help guide some of your planning after there has been a disaster or an emergency. As Neal said at the opening of today's webinar, we focused today more on preparedness, but we will have an opportunity in the coming months to also talk to you about some concrete actions during the response and recovery stages. Next slide, please. 

Here are some wonderful resources in our Head Start Heals Campaign that we encourage you to look at that can help you think about the impact on children and adults during stressful times, including during a hurricane that you can use as you're thinking about your mental health response to meet the needs of children and adults among our children, families, and staff so that you can support their health, their safety, and their mental wellness as well. next slide. 

I think there's only one more we're sort of at the top of the hour. I think there's only one more question that I haven't answered. It was the, are there new emergency preparedness manuals available? coming soon. Certainly, make use of the materials that are available from our center and from the National Center on Program Management and Fiscal Operations. 

If you have needs and you're looking for something and you don't know, I really one takeaway for me is I'm going to go back and look at the draft of our revised manual and see, what did we say for home visitors? Because I heard loud and clear that sometimes it feels to some of you that maybe that has not been addressed as coherently as it might be. I will pay particular attention to that. If you want your certificate… Can you just go back one second, Mercedes? It's in the chat as well. Here is both a QR code and the link to your evaluation. When we close out, if you complete the evaluation, you'll be redirected to get your certificate. Next slide, please. 

I think you are aware, or most of you are aware, that there has been a proposed rule that so the Notice of Proposed Rulemaking is available for public comment through the 19th, which is this week, and would be thrilled to have you enter any comments that you would like to make. You can use this information, if you haven't done so already, and think that this is something that you would like to do. Next slide, please. Thank you to all of you who stayed with us. I hope that you were able to hear and learn some things today. If you are interested in subscribing to our mailing list, this is a handy URL that you can use to get monthly updates from the National Center.

Then last slide before we close out is social media. I also saw there was a question about whether there are templates that you all could use for social media for your own campaigns. I suggested that we have some that you write to ECLKC. You might want to put that question on MyPeers, but that's something else that we can talk about internally. Thank you for that question.

We really do pay attention to the things that you ask us to identify emerging needs that we may not have addressed as fully as we might. Stay connected with us through all of those ways. Here's how you can find us. You can find our materials and you can write to us at health@ecetta.info, and we're always happy to hear from you. Thank you for joining us today, and I hope everyone stays safe and stays warm. Kate will close out the webinar in just a moment.