Joint hearing of Mental Health, Mental Retardation, Alcoholism, Drug Abuse &
Disability Services Committee, Aging Committee and Fire and Criminal Justice Services Committee
September 25th, 2008

Good Afternoon Chairperson Koppell, Arroyo, Martinez, Vacca and members of the committee. My name is Dr. Michael Dueñas. I serve as the Executive Director of Professional and Public Health Education at Lighthouse International and I am testifying on their behalf. Lighthouse International was founded in 1905 and is dedicated to preserving vision and to providing critically needed rehabilitation services, education, research and advocacy to help people of all ages overcome the challenges of vision loss. Lighthouse International has been a leader in vision healthcare for New Yorkers for more than 103 years. I thank you for the opportunity to testify before you today and to share with you Lighthouse's unique perspective as it relates to emergency evacuation of the visually impaired community (one that is currently estimated at 1 million, in the NYC area alone, and expected to double by 2020 as a result of changing demographics, our aging population and increased levels of chronic diseases such as diabetes and hypertension.) As you know events such as Hurricane Katrina, the midtown steam pipe explosion and most recently, Hurricane Ike, bring to light the importance of developing evacuation plans that address the needs of the visually impaired.

New York City's Emergency Action Plan is an important step in preparing buildings for evacuation scenarios. While it is a comprehensive plan, we offer the following suggestions to ensure that the needs of the visually impaired are further incorporated:

Identification of Visually Impaired Occupants
Identification of people with visual impairments is an important component of this plan. The more people identified prior to the occurrence of an emergency the better likelihood that one will be prepared for evacuation. As noted in subsection 8, the current plan relies on occupant self-referral for identification of special needs request. In the case of vision impairment, occupants may be socially isolated, fearful of disclosing vision impairment information or simply not fully aware of the vision demands of safe evacuation. Surveillance through survey and modifications to EPA drills could provide a more accurate assessment of actual need.

Training of Emergency Service and Building personnel
It is important to understand the proper procedures and protocol for guiding a person with visual impairment. This plan does not make reference to requiring any such training of building personnel or emergency service personnel. The likelihood that a person with visual impairment is also suffering from co-morbidity is high and furthers the need for training building personnel and emergency providers on proper techniques for guiding a person with visual impairment to safety.

Accessibility of educational materials
The emergency action plan makes reference to the preparation of educational materials for building occupants. Designed to familiarize occupants with the emergency action plan, this educational material must take into account building occupants who may be visually impaired and be translated into large print, Braille or other methods of accessibility for people with visual impairments.

Potential Vision Field Loss of Occupants
Of the four major Age Related Eye Diseases, three including; Glaucoma, Age-related Macular Degeneration (AMD) and Diabetic Retinopathy often include vision field loss, as well as vision acuity loss. The potential for the environment to change, as a result of an emergency situation, may have predictable adverse outcomes that can be avoided through advanced planning. Technologic advances in Way Finding together with Orientation and Mobility Training Techniques may be important elements to consider.

Potential for Non-Visually Impaired to become Visually Impaired
The possibility of non-visually impaired occupants becoming visually impaired, as a result of chemical release is real. The plan, in its current state, does not address the potential for a large percentage of building occupants becoming visually impaired or blind as a result of a natural or man made event.

In conclusion, Lighthouse International believes that our suggested considerations for enhancements to this rule have the capacity to further safety and protect the health of all occupants. The challenge of a comprehensive public health approach involves the detailed analysis of a triad of interrelationships including the Host (occupants), Agent (s), and the Environment. Issues related to vision impairment and blindness transcend all three. Lighthouse International, located here in NYC at 59th and Park, stands ready to assist you in meeting your overall objective of guarding the public's safety and health through supporting the incorporation of any of these suggested modifications to the existing rule or through engagement in enhancements to education contained within the rule.

Thank You



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