Mr. Chairman, Senator Clinton, Senator Schumer, members of the Committee, I am Igal Jellinek, Executive Director of the Council of Senior Centers & Services of New York City, and I welcome the privilege of appearing before you.
      By way of background, the Council of Senior Centers & Services of New York City is the premier professional organization for the City's senior service providers. A nonprofit organization founded in 1979, CSCS currently represents 265 senior service organizations, ranging from individual community-based senior centers to large, multi-purpose citywide organizations. Among them, our members sponsor 340 senior centers as well as settlement houses, community centers, nursing homes, adult day centers and mental health agencies. CSCS members include: case management and home care agencies working with homebound elderly, elderly housing providers, and transportation services (including vans and agreements with local car services).
      We also provide a variety of programs and services, including: technical assistance and training; public policy updates; government education and advocacy; idea exchanges; direct participation in citywide committees and coalitions; and publications on the issues affecting senior service providers and the older people of New York City and the surrounding area.
      New York City's five boroughs are home to some 1.3 million seniors. Moreover, the 85-and-over seniors is the fastest growing segment of New York City's population. According to federal sources, there were some 6,300 seniors living around the area of the World Trade Center's Twin Towers, and nearly 19,000 older adults living within a three-block radius.
      Thanks to the John A. Hartford Foundation of New York City, we are now at work on the first part of a four-pronged project entitled, "September 11, Responding to the Needs of Older New Yorkers," the first part of which will produce an Emergency Planning Guide for New York City's Senior Services Providers. The handbook will address issues arising in a disaster -- be it a natural or "unnatural" disaster -- under the broad categories of home care coverage, Meals on Wheels deliveries, shelter, transportation, communication (including the need for "calling trees" and offsite data storage), accessibility for home care aides, and emergency preparedness training both for providers and for the older adults themselves. As many seniors in the settings of our providers are also disabled, our work has broad implications for all people who have limited mobility. Thanks to the generous support of the Hartford Foundation, we will share copies of this handbook with our 265 member agencies, and will make it available on our CSCS website.
      We have begun the process of gathering data both from our members, and from organizations and communities throughout the country that have had to cope with disasters of large proportion, including communities in Oklahoma City and in California. We convened a daylong conference last month, called "Managing Change in Turbulent Times," where our speakers addressed issues that arose for providers of services to the aging community. Speakers from the American Red Cross and FEMA talked with our participants about emergency preparedness issues. We also surveyed our members to find out the problems they faced as a result of the events of 9/11, the solutions they developed, and the issues that remain to be addressed. We thus have a great deal of information on what the issues are, some of the solutions our members developed, and some of the challenges that remain.
      Regarding the problems our members and their seniors faced as a result of the most recent and horrific emergency situation, on September 11 of last year, I think the good news is that we have all learned a great deal from how they coped with these problems. As you will hear, their solutions are both innovative and compassionate. But you will also hear what we feel is the most important solution of all: That we as aging services providers, need to join with members of communities, members of social service agencies, with city, state and federal government and the private sector, to pool our resources to truly prepare for a unified, integrated, and effective response to emergencies.
      That said, there are five overarching categories of need:
1. Getting services to the homebound and the disabled
2. Ensuring that our seniors have adequate food, water, and shelter
3. Transportation -- of people, services, medications, and food
4. 360-degree communications with staff, seniors, their families, and emergency organizations
5. Addressing the mental health issues that arise for everyone.
      I'm sure you've noticed, as I have, that the issues in these broad categories seem to blend and be somewhat interchangeable - - they are all about matching and transporting the services and commodities to the people who need them.
      Let me give you some examples, beginning with the homebound and disabled. At Sunnyside Community Center and Senior Center in Queens, serving 1,500 seniors, they have an emergency planning system in place, that includes getting the names of three emergency contact people for each client, and setting up a triage of client needs. They classify their homebound clients on a three-level scale: Level One means they cannot be left alone, level two means they can be left alone briefly, and level three means they can function independently. Sunnyside also gives each of its home care clients a brochure entitled, "Emergency Preparedness for Home Care Patients." Part of the emergency plan includes updating this information monthly, and ensuring that the client's level of need has not changed. In addition, Sunnyside keeps both a hard copy and a computer file of their clients, and shares both with the Fire Department and the Police Bureau commander. Thus, in an emergency, they immediately know which of their clients need help first.
      But the problem arose, on September 11, and in the following days, that many of the homecare workers could not get to their homebound clients because they didn't have official photo identification badges to enable them to get through the blockades. These are the small but critical issues that our members have alerted us to and that together we can remedy.
      At Stanley Isaacs Neighborhood Center on the Upper East Side of Manhattan, which is also a "Meals-on-Wheels" provider, they were serving congregate meals in their senior center on September 11 when tragedy hit, and they continued to serve their seniors that day, making sure they were given their lunch.
      But they could not carry out their Meals-on-Wheels program, because the trucks that brought in the food were stuck out in Queens, with the bridges and tunnels shut down. This is a problem that cut across all five categories of getting services to the homebound and disabled, transportation issues, communications issues, and mental health needs arising from the emergency. If a homebound person does not get his or her meal, it is first a physical issue, but quickly becomes an emotional one as well, as isolation, fear and panic set in, all with terrible consequences for the homebound person.
      The solution: A brace of some 24 corporate volunteers from Bloomberg Communications, to deliver "Meals-on-Heels," by going door to door on foot; and the generous help of two restaurants in the area, namely, the world-famous Le Bernardin, and "Daniel," that donated food to feed the Center's homebound clients.
      And as Karen Alexander, Director of Program Development at Stanley Isaacs, said, "On September 12, I found myself in a hairnet making ham and cheese sandwiches." In addition, the Bloomberg volunteers and Isaacs Center executive staff, led by Executive Director, Wanda Wooten (who is also President of CSCS) all pitched in to package the food from the restaurants so that it could be transported to its homebound clients.
      Regarding the issue of adequate shelter, this became much more of a problem than it had to be. For our providers who had to find shelter for their clients, each one said that they needed to have a list of shelters available in an emergency, but that no such list existed. Many of our members told us they were never told of any emergency shelters during the tragedy of 9/11 and its aftermath.
      At VISIONS, which serves some 1,800 community-dwelling blind people per year, plus another 450 residents and community users of its 23rd Street Selis Manor facility, many blind and disabled seniors had gotten to its 23rd Street facility via paratransit vans, but the vans couldn't get back into Manhattan to pick them up. VISIONS Executive Director, Nancy Miller, both arranged for private car service for her clients, and made the 23rd Street facility available so that any blind person stranded around the City could go there.
      One of VISONS' volunteers, an 80-year-old retired accountant, had gone to the 23rd Street facility, and was in tears over not being able to get home to the Bronx.
      The solution? Long-time Executive Director, Nancy Miller, arranged for private car services to take people home. She realized too, that transportation would be disrupted for a long time, and as a result, people were afraid to leave their homes, afraid they couldn't get back. Under the direction of Ms. Miller, VISIONS was extremely well prepared for an emergency; under her leadership, they also performed triage similar to Sunnyside, in that they checked on the safety first of their clients, next of their staff, and last, of their agency building. VISIONS made its 23rd street facility available so that any blind person stranded around the city could go there. Ms. Miller told the staff to use their credit cards and go out and get bottled water, flashlights, food, whatever they thought anyone would need, staff and clients alike. Further, Ms. Miller had worked with her insurance company three years ago, to do an audit of risk factors of VISIONS to limit exposure to risk. Among the recommendations of the auditors were: keeping an inventory off-site of hardware and software; keeping a list of ID nos. and vendors on their machines, and taking out "key employee" insurance on herself and on the controller for the agency, as well as business interruption insurance.
      For some clients of VISIONS, the anthrax scare also became an emergency: Many people with limited vision can only read things very close to their face; so VISIONS did a major volunteer recruitment, and set up facilities for any blind person in the city to go to Selis Manor and have someone read their mail to them.
      Transportation issues -- including of food, people, medications and services, also loomed larger than life during the 9/11 disaster. Transportation problems became the central issue -- preventing people from receiving needed supplies of food and medications, keeping people away from their homes and families, given the City's need to close down all bridges and tunnels. While this may have increased safety for the island of Manhattan and the outer boroughs, it sent senior services providers with without local emergency backup scrambling to cover the necessities that we took for granted before the attack of 9/11. And the "roads were a mess," as one of our members put it.
      And on the issue of 360-degree communications -- that means communicating with staff, with clients, with emergency service operations, and with anyone else you need to reach or who needs to reach you -- this also became a problem for our members, depending, of course, on where they were located.
      Our members have asked us for help in creating "redundant communications plans," that is, multiple ways of communicating in an emergency that includes backup if one method doesn't work. This is something we need to address going forward, including the use of cell phones, backup land lines, two-way radios, a special radio band for emergency communications and broadcasting, and, of course, ensuring that every person has a portable radio and fresh batteries.
      Some of our members have created "call down" systems, where people can call in to them, and they can try to contact emergency services; but when the phone lines were down and cell phones not working, this fell apart.
      Many are worried about both what role they need to play in the event of a bioterrorist attack, and how they can also protect their seniors.
      And then there are mental health services. As was true with communications issues, mental health services needed to be offered in a 360-degree manner as well. That is, everyone needed to talk, or someone to talk to, or cry to; or some needed to be the one that others could talk to. All of our members told us that participation in their congregate facilities increased, sometimes double what it was before 9/11. Senior centers became safe havens for our city's older adults, as our members told us of the clear need seniors had to be in touch with someone and not to be isolated.
      Universally, we heard from our members that they instituted whatever mental health measures they could -- from informal sessions on PTSD, to Employee Assistance Programs, to special meetings for older people for whom the 9/11 tragedy brought up painful memories of past tragedies and losses. Our Board member, Linda Leest, Executive Director of "Services Now for Adult Persons," or SNAP, in Eastern Queens, tells us that SNAP has a large population of older men. Many of these men began talking -- some for the first time -- about the horrors they experienced during World War II. All of our members told us that participation in their congregate facilities increased, sometimes double what it was before 9/11. And everyone told us of the clear need seniors had to be in touch with someone, anyone -- to stave off the terror of isolation amid a disaster of such earthshaking proportion. Unfortunately, many seniors -- for whatever reason -- were caught without radios. Many lost cable capability on their television. As a result of that one- two punch, they were desperate for information that was not forthcoming. One of the universal needs of emergency preparedness -- which we hope to remedy in future, at least for our seniors, and, ideally, persons with disabilities, is the need for a transistor radio, along with plenty of fresh batteries.
      Each of the coping mechanisms our members designed to meet the issues raised by the terror attack is ingenious. But therein lies a larger problem. They should not have had to work on their own to solve the problems that they all shared. Instead, we need a community-level preparedness plan, where all stakeholders work together. And we need to begin now.
      And here is our most fervent plea: That we all join together -- private sector and government, in all our diverse forms, and put together a plan NOW that pools our resources and ensures that we respond to emergency situations of any kind on a community or neighborhood level.
      Member after member of Council that we spoke to - including our most ingenious problem-solvers -- only a mere few of which you have heard about today -- pleaded with us to take their case to those who can ensure that emergency preparedness planning take place at the Community Board level, and include a partnership of all the tremendous resources our communities have to offer, including our Aging Services Network, our foundations, corporate partners, restaurants, and, of course, our citizens. The "best practices" solutions are critical on an operations level -- and are borne of the most tragic of circumstances. But as one of our members said, "None of us should have had to scramble to find solutions to problems that all of us faced." So if there is one take-home message, it is that we all need to work together as a community to prepare for the next emergency situation, and we must begin today. We know what we've learned, and we know what we need to do, and the first thing we need to do is collaborate on a community level with all stakeholders work together. Immediately.
      Now that I've mentioned a few of the problems, here are some additional emergency preparedness suggestions from our members:
¤ Develop a network of emergency pharmaceutical services that includes the means both to fill medications and get them to those who need them; we need to find a way to get prescriptions to our community-based seniors as well.
¤ Increase in-home services for the homebound, including in- home psychiatric/mental health services and home health aide providers, and offer these services as well for seniors at senior centers
¤ Ensure that there is a team of restaurants identified in a neighborhood as willing/able to provide emergency food to a pooled resource
¤ Maintain a bank of names of volunteers, both of neighbors helping neighbors, and of people in local institutions who would like to volunteer to help others in the community.
¤ Make sure private buildings maintain a list of people in apartments who may need assistance; ask people on each floor to volunteer to look out for seniors and people with disabilities who might need help.
¤ Create a database of older adults who want to volunteer in local schools, should an emergency arise
¤ Develop an emergency support system for in-home services, including emergency respite care and communications abilities for in- home caregivers
¤ Create a secure system of photo identification for professional healthcare and senior service workers (including CityMeals/Meals-on- Wheels provider vans and drivers) that will enable them to get through to their homebound clients in an emergency
¤ Ensure that each facility has done a risk-assessment audit of its hardware, software, insurance coverage, and physical plant
¤ Develop a city-wide, statewide and nationwide emergency transportation plan; each community needs a contingency plan for moving people, (including those in wheelchairs), emergency supplies, and medication.
¤ Upgrade communications systems (including trunks of phone lines and emergency response systems), and develop "redundancy" communications plans, including instructions on use of emergency communications products and tools with backup.
¤ For Meals-on-Wheels program, offer the "sixth meal," or the shelf- stable emergency pack, in case of interruption of service. Instruct the providers to offer the homebound strict instructions that this "sixth meal" is for emergency purposes, and should be saved for such purposes, if at all possible.
¤ Ensure that on the organization level, each organization develops an emergency plan -- and teach them to remain flexible, depending on the nature and site of the emergency
¤ Communicate with your clients and staff immediately and as continuously as possible; ensure that people do not feel isolated or abandoned
¤ Understand that your staff may feel a need to offer help and to be helped; offer group discussion sessions, and, if possible, allow staff release time for volunteer efforts.
      On that note, in addition to the Hartford Foundation, I also want to thank The Atlantic Philanthropies for their generous donation to CSCS Member Agencies in the wake of 9/11. With their generosity, we were able to reimburse agencies for some of the emergency money they spent on 9/11 and in the following days.
      Thanks to the Atlantic Philanthropies, we were able to offer generous grants as follows, to the following seven agencies:
¤ The Caring Community at 20 Washington Square North in Manhattan, to reimburse them for food and water provided to seniors in the community between September 11 and 21, 2001, and to provide crisis training and workshops for staff to help them work more effectively with older people in the community.
¤ The Chinese-American Planning Council, Project "Open Door," at 115 Chrystie Street in Manhattan, to purchase Chinese/English language radios, emergency food packages, and battery- operated flashlights and alarm clocks, all for seniors in the agency's lower Manhattan catchment area.
¤ Community Food Resource Centers, 39 Broadway, for additional social work and outreach workers to support existing staff, as well as support for friendly visitors to older people in the vicinity surrounding Ground Zero, and to purchase cell phones as well as pay for charges related to cell phones for staff in the wake of constant service interruptions of land line telephones in the area.
¤ The Educational Alliance, 197 East Broadway, to fund one staff member for a three-month period to provide intensive counseling, workshops and other assistance related to September 11.
¤ Hamilton-Madison House, City Hall Senior Center, 100 Gold Street, for newspaper advertisements announcing the 100 Gold Street senior center opening (replacing the center closed in the aftermath of September 11). In addition, the grant went to cover the cost of additional staff time in assisting the American Red Cross in translating materials for mental health workshops to be conducted in Chinese, and to provide additional meals at the Gold Street senior center, as a result of increased attendance at the new facilities of seniors who wanted to be with others.
¤ The United Jewish Council of the East Side, at 235 East Broadway, to provide direct counseling services for seniors and families affected by the World Trade Center tragedy and its aftermath.
¤ And to VISIONS, at 500 Greenwich Street, to support an emergency mobility fund to provide transportation for older people who are blind or visually impaired and unable to use public transportation or Access-a-Ride due to service interruptions in the wake of the September 11 tragedy.
      I also want to thank our members of CSCS, each of whom contributes so much every day to the physical and emotional health of our at-risk and vulnerable seniors in New York City. And I especially want to thank those members who shared their stories and ideas with us in support of this work on emergency preparedness, including CSCS President, Wanda Wooten, Executive Director of the Stanley Isaacs Neighborhood Center; Nancy Miller, Executive Director of VISIONS; Glee Kleinberg, Executive Director of Sunnyside Community Center; Linda Leest, Executive Director of Services Now for Adult Persons (SNAP); Melissa Gorton, Director of Hamilton-Madison House, and Janet Fisher, Director of Senior Services at Henry Street Settlement House; and Fredda Vladeck, Director of the Aging in Place Initiative for the United Hospital Fund; Thanks also to Council members on our Advisory and Review Committees for the handbook, to my devoted CSCS staff here in Manhattan, including Bobie Sackman, and to Danylle Rudin and Ann Gross.
      Again, I appreciate the opportunity to appear before you, and I'd be happy to try to answer any questions you might have.

Emergency Preparedness for Seniors in the Private Sector, Igal Jellinek, Executive Director,
Council of Senior Centers & Services of New York City, Inc., February 11, 2002
Emergency Preparedness for Seniors in the Private Sector, Igal Jellinek, Executive Director,
Council of Senior Centers & Services of New York City, Inc.






©Ann D. Gross