2025 LA Wildfires Impact on Older Adults Report

2880 Gateway Oaks Drive, Suite 390, Sacramento, CA 95833 916.419.7591 | ccoa@ccoa.ca.gov | www.ccoa.ca.gov

The California Commission on Aging

The California Commission on Aging serves as the principal advocacy body for older Californians and as a catalyst for change that supports and celebrates Californians as they age. The Commission's work on behalf of older adults reflects the values of equity and inclusion; autonomy, choice, and access; respect and integrity; collaboration and partnership. The California Commission on Aging advises the Governor and Legislature, along with state, federal, and local agencies on programs and services that affect older adults. The Commission works closely with public, nonprofit, and private-sector partners to address emerging challenges and opportunities. Established in the Older Californians Act, the Commission is comprised of 18 appointees representing the state's racial, ethnic, and geographic diversity. Members of the Commission are consumers and providers of aging services, as well as researchers and academicians from the field of aging. Commissioners are volunteers who serve up to two three-year terms, appointed by the Governor, the Speaker of the Assembly, and the Senate Rules Committee. Meetings of the California Commission on Aging are open to the public. Visit ccoa.ca.gov for information on current and past CCoA meetings.

COMMISSIONERS COMMISSION STAFF

Karol Swartzlander, Executive Director Marcy Adelman Patrick Smith, Policy and Research Analyst David Campos Marijke Melman, Outreach and Engagement Analyst Erika Castile

1. Michael Costa PANELISTS Adriene Davis Dr. Laura Trejo, Director, Los Angeles County Aging & Disabilities Department David Lindeman Rachel Tate, Vice President, Ombudsman Services, Wise & Healthy Aging Janet Frank TJ Hill, Executive Director, Disability Community Resource Center Brendalynn Goodall Sue Kujawa, Altadena resident Ben Jauregui Tracie Mann, Chief of Programs, Los Angeles County Development Authority Jaime Jensen David Lindeman (Chair) Bertha Sanchez Hayden, Associate Vice President of Justice for Seniors and Dependent Adults, Bet Tzedek Shelley Lyford Jeannee Parker Martin Tierre Thornton, Executive Director, Ivy Park at Culver City, Los Angeles Debbie Meador Joe Cobery, Director, Passages Area Agency on Aging Faisal Qazi Laura Mosqueda, M.D., Professor of Family Medicine, Geriatrics, and Kathleen Selenski Gerontology, Keck School of Medicine and Leonard Davis School of Lenore Tate Gerontology, University of Southern California Lindsey Yourman John Burke, Corporate Safety Officer, Human Good Dana Toppel Katie Brandon, Director, Pasadena Village ii Ca lifornia Commission on Aging

Table of Contents

LETTER FROM THE CHAIR..................................................................................................... 1

EXECUTIVE SUMMARY .......................................................................................................... 2

INTRODUCTION ..................................................................................................................... 4

FINDINGS .............................................................................................................................. 4

COMPLICATIONS AT THE ONSET OF THE FIRES....................................................................................... 4

EVACUATION CENTERS DURING THE EATON FIRE................................................................................... 6

OLDER ADULTS FACE LONGER RECOVERY.............................................................................................. 7

PREPARING FOR THE FUTURE ................................................................................................................. 9

RECOMMENDATIONS..........................................................................................................11

LOCAL ADMINISTRATIVE ACTIONS ......................................................................................................... 11

STATE ADMINISTRATIVE ACTIONS.......................................................................................................... 11

LEGISLATIVE ACTIONS............................................................................................................................ 13

EFFORTS IN PROGRESS......................................................................................................................... 15

NOTES .................................................................................................................................16

California Commission on Aging iii

LETTER FROM THE CHAIR

November 5, 2025 Dear Reader, The disparate impact the January 2025 fires in Los Angeles County had on older adults and people with disabilities provided an insight into a harsh reality plaguing California's emergency planning. That is, vulnerable populations are still disproportionately victims of natural disasters. And after the immediate danger of a natural disaster has concluded, many older adults and people with disabilities lag in the recovery process--left in precarious positions lacking the stability they once had. In response, the California Commission on Aging (CCoA) held an informational hearing in May 2025 to gain insight into the issues surrounding older adults and emergency response and recovery. The Commission heard from assembled panels of experts in emergency management, aging and disability services, long-term care, and community advocacy - many of whom were directly involved in the response efforts. The hearing provided insight on the challenges that face the communities of Altadena and Pacific Palisades, what can be expected in the near future, and how state and local government can better prepare for the next disaster. While the hearing was not intended to be a full post-analysis of the emergency response, CCoA found that the response efforts in the Eaton and Palisades fires fell into many of the same patterns as other disasters - overlooking older adults and people with disabilities. The Commission discerned some of the glaring issues that plague recovery victims and looked to past wildfire events to determine where Los Angeles County could be heading in the wake of these events. The Commission has offered a series of recommendations based on the report's findings to promote emergency response and recovery efforts that integrate the needs of older adults and people with disabilities. The hope is that policymakers, state and local agencies, community organizations, and individuals will use these recommendations as part of a comprehensive strategy to mitigate the tragic toll disasters have on aging and disability communities. Moving forward, it is critical to enact policies and advocate for change on this urgent issue. As California continues to experience increasingly devastating natural disasters and as our population ages, we must ensure that older adults and people with disabilities have a voice in emergency planning and response. CCoA remains dedicated to uplifting these voices and ensuring they are heard. Sincerely,

David Lindeman Chair, California Commission on Aging

California Commission on Aging 1

Executive Summary

Disasters disproportionately affect older adults and people with disabilities. The Los Angeles area wildfires in January of 2025 claimed the lives of at least 31 residents, 26 of whom were either over the age of 65 or had a disability. Even with such figures becoming the norm, local agencies are not integrating their most vulnerable residents into emergency planning. Many individuals, especially older adults, have not prepared for disasters with a plan or the necessary evacuation resources. Those fortunate to evacuate face additional challenges. Evacuation centers during the Eaton fires lacked data on residents with access and functional needs, leading to shortages of accessible equipment and critical medical supplies. Medical staff were overwhelmed, and many lacked experience and training in the specialized needs of older adults and people with disabilities. Recovery is often longer and more arduous for older adults. Those who have lost homes face barriers to rebuilding and rehousing in a strained market beyond their means. Navigating insurance is complicated and compounded by a lack of legal resources. Additionally, growing evidence shows unscrupulous and illegal business tactics are perpetrated on older adults who have lost their homes. Older adults may experience lasting instability after a traumatic disaster. The loss of a long-term facility drastically alters a resident's continuity of care, while behavioral health issues persist long into the recovery process and compound existing behavioral health needs. Previous fires, like the 2018 Camp Fire in Paradise, show that widespread displacement of older adults can persist and reshape entire communities. State and local agencies must prepare for more frequent and intense natural disasters by focusing on their most vulnerable residents. Local groups are crucial to fostering resiliency in the populations they serve. They are integral to providing recovery services while strengthening communities through member-driven collaboration. CCoA has compiled the following recommendations to strengthen disaster response, recovery, and preparedness for older adults and people with disabilities.

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Recommendations

The following table lists the Commission's recommendations based on their area of action:

evacuation sites in of a disaster registry Term Care Mutual Aid emergency plans System response with local aging Justice Task Force on preparedness funding to & disability organizations disaster scams AAAs & Independent Living Centers representation on recovery housing aid Legal Services Fund planning boards program Functional Needs servicers to provide Emergency Training counseling referrals

Pre-designate emergency Explore the establishment Establish a state Long-Coordinate disaster Launch CA Department of Provide disaster Ensure older adult Reestablish a disaster Develop a State Disaster Amplify Access and Require reverse mortgage California Commission on Aging 3 LOCAL ADMINISTRATIVE STATE ADMINISTRATIVE LEGISLATIVE ACTIONS ACTIONS ACTIONS

Introduction

The devastating impact of the January 2025 wildfires in Los Angeles County cannot be overstated. The Eaton and Palisades fires, the most destructive of the blazes, burned more than 37,000 acres, destroyed over 18,000 structures, and claimed at least 31 lives. Of the 31 identified victims, all but four were over age 65 or had a disability, with a median age of 76. 1 The California Commission on Aging (CCoA) hosted an informational hearing in Los Angeles in May 2025 to better understand the conditions that lead to such alarming and tragic outcomes and how recovery efforts in the area are progressing. The hearing also explored how state and local agencies can prepare for future disasters. This report is based on hearing testimony from experts in aging and disability, medical and governmental staff who responded to the fires, and members of the aging and disability community who were displaced. Based on this testimony, the report outlines recurring complications for older adults and people with disabilities during wildfires that contribute to disparate outcomes, with a focus on the specific challenges of the Eaton and Palisades fires. The report addresses barriers to recovery and provides a framework for expected outcomes in the future. It seeks to answer the question: "How can California prepare for an aging population likely to face more frequent and increasingly intense natural disasters?"

Findings

Complications at the Onset of the Fires information to direct recipients to emergency

shelters or to show areas under evacuation orders. Most disasters create similar challenges for Graphic information may be difficult to interpret by older adults, and the Los Angeles wildfires were individuals with low vision, especially those who rely no exception. Understanding both the common on text-to-speech applications. challenges that arise in disasters and the

specific issues that occurred during the initial Alerts typically emphasize sharing as much information as possible and include links to outbreak of the Los Angeles fires can help us resources. Many older adults may dismiss text better prepare for the next major disaster. messages that are "walls of text" rather than simple Emergency Alerts Are Not Accessible to All. pertinent information. Ongoing efforts to advise Local emergency agencies generally use mass text older adults on how to avoid text scams might messaging to alert residents of evacuation orders conflict with emergency agencies trying to and provide emergency-related information. Many coordinate mass outreach through a "one size fits people, particularly older adults, are reluctant to use all" alert. text messaging or dismiss text messages not from Limited Mobility Hinders Older Adults and People trusted contacts. Others may use landlines as their With Disabilities During Disasters. A quick response primary method of communication. to evacuation orders is critical to surviving rapidly For those that use text messaging, alerts may not developing disasters. Older adults and people with have accessibility standards that prioritize disabilities may have limited mobility, which can functionality over other considerations. For example, slow or prevent evacuation. Accounts from friends alerts for evacuation often focus on map-based and relatives indicate that many victims of the Eaton

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and Palisades fires were aware of the dire not have time to rescue these individuals with some circumstances they faced but simply had no way to dying believing rescuers were on the way. 6 evacuate without assistance. 2 Reliable data remains a challenge for emergency Older Adults Do Not Regularly Plan to Evacuate responders, even when residents reach an Their Homes in an Emergency. During the Eaton fire, emergency evacuation shelter. Staff at shelters lack emergency operations quickly transitioned from medical information about incoming evacuees, fighting the fire to evacuating surrounding homes. sometimes critical to ensuring necessary care. This 3 Typical wildfires burn up to 895 acres per day, the can lead to shortages of necessary resources and equivalent of half a football field a minute. Fueled by delays in providing continuing care for medically a myriad of dangerous conditions, the Eaton fire fragile displaced residents. burned at a rate of seven and a half football fields a Communication Issues Hinder Appropriate Care. minute. Firefighters faced the nearly impossible 4 Without personalized medical information, task of evacuating all of Altadena as the rapidly emergency shelter staff must rely on evacuees or moving fire bore down on the community. their caregivers to communicate existing medical Best practices in emergency preparedness stress needs. Communication is difficult in an emergency, the need for individuals to plan for disasters, and is complicated when evacuated adults have including rapid evacuation should their home come dementia, Alzheimer's, or age-related cognitive under threat. Individual emergency planning is impairment. critical to survival. However, despite targeted At the same time, emergency responders may campaigns to highlight the importance of assume older adults have cognitive impairment preparedness, many older adults still lack a plan to when they are merely overwhelmed by trauma and a evacuate their homes in an emergency. In a national chaotic environment. Ageism can lead to survey, fewer than one in three adults age 50 to 80 misallocation of resources and inappropriate care. had a stocked emergency kit. 5 Witnesses at evacuation centers reported that Emergency Response Systems Lack Data on medical staff used a misdiagnosis of dementia to Vulnerable Residents. During emergency dismiss and neglect evacuees' real needs. 7 evacuations, first responders have no way of Communication challenges are exacerbated if knowing the status or location of older adults and shelter staff lack ethnic or cultural awareness. people with disabilities. Many residents cannot leave Language barriers, for instance, create additional their homes without assistance. These residents obstacles that make providing quality care in an must rely on others to provide transportation or emergency nearly impossible. Culturally competent rescue when swift escape from danger is critical. and multilingual staff are not only necessary for the However, without data identifying the location of comfort of evacuees but also essential to providing vulnerable residents, emergency responders are appropriate care. unable to assist. Many of the victims of the Eaton and Palisades fires perished because there was simply no way for first responders to know which homes housed individuals who required assistance. Some homebound adults dialed 911 to give their location to dispatchers. However, emergency responders did

California Commission on Aging 5

Evacuation Centers During the Eaton Fire high-voltage outlets, and other necessary

infrastructure to support medical equipment needs. Firsthand accounts of issues at Eaton fire

emergency evacuation centers provide further The facilities and equipment were insufficiently

insight into the complications that older adults accessible to many older adults and people with

face once evacuated. disabilities in the community. Most shower stations were not large enough to allow for wheelchairs or Jurisdictional Issues Plagued Coordination at had steps instead of ramps. The cots supplied did Evacuation Centers. The Eaton Canyon fire largely not accommodate those with mobility constraints. 10 devastated the unincorporated community of Local Health Systems Needed Time to Mobilize. Altadena, bordering the city of Pasadena. AltaMed and Kaiser Permanente provided critical Evacuation orders directed most residents to the care and supplies to the evacuation centers on the Pasadena Civic Center in the jurisdiction of the third day of the disaster. However, in the interim, Pasadena City Police and Fire departments. There, there was a shortage of available medical staff and staff from the Los Angeles County Department of equipment. Emergency agencies had not Public Health, Pasadena Public Health Department, coordinated with local health systems to ensure that and community organizations converged without a healthcare providers could be quickly deployed to centralized command structure. evacuation centers. Many providers showed up at As more residents began to flow into the Civic centers on the first day of the disaster on their own Center, growing confusion overtook intake and care. accord, not in response to a request by an Multiple agencies and volunteers from organizations emergency response agency. endeavored to provide evacuees with care without Part of the delay in deploying medical staff was due coordination. Older adults and people with to the speed of the unfolding disaster. However, disabilities - whose needs often require urgent local emergency plans did not ensure that local consideration - were left neglected in the chaos. 8 healthcare systems would be immediately engaged Critical Equipment Was Missing at Evacuation during a disaster. Centers. In the hours directly following the outbreak Emergency Agencies Did Not Coordinate with Aging of the Eaton Fire, the Pasadena Civic Center served Resources. Area Agencies on Aging (AAAs) are as the primary emergency evacuation center. The responsible for providing a wide range of services to facility lacked the medical facilities necessary for an local older adults. However, in the immediate older population arriving from evacuated homes and aftermath of the Los Angeles fires, local AAAs were nursing facilities. Beds, medical stations, and 9 not fully utilized and, in some cases, were barred intake systems were absent and required days to from participating in response efforts at evacuation take shape. centers. 11 The center was lacking in critical medical supplies needed to stabilize people with specialized needs. Basic medical equipment, such as personal protective equipment for staff, wound care supplies, glucometers, and blood pressure cuffs, among other supplies--could not be found. Additionally, the Civic Center lacked an ample supply of power, including

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Older Adults Face Longer Recovery loans are attractive to older adults without sufficient

income but equity in their home. 13 Older adults trying to return to their lives after a

disaster face additional barriers. Disasters often Since a reverse mortgage uses the borrower's home

amplify disparities preiously not apparent. as collateral, those with reverse mortgages who lost their homes in the Eaton and Palisades fires are Low-Income Older Adults are Particularly Vulnerable faced with the option to either rebuild their house or When a Home is Lost. "House-rich, income-poor" repay their debt. If they choose to rebuild, they must older adults on fixed incomes who hold equity in navigate insurance, contractors, and permitting, all their home may not have the ability to rebuild while managing limited funds and a reduced home without extensive financial and navigational support. equity - not to mention finding interim housing and These individuals must rely on family or other coping with trauma. support groups to maintain stability. Without these If the borrower's insurance only offers a number far support networks, they are likely to be placed in below the appraised value of the home, the institutional settings or become homeless. borrower may not have the ability to rebuild and Navigating Insurance Can Be Overwhelming. instead must use their insurance payment to settle Insurance companies are inundated with claims the balance on their reverse mortgage. The borrower after major disasters. Delays in claim approval can then may be left in a position without the equity they leave older adults without the financial resources once held in their home, the income they were necessary for recovery. A surge in claims can lead to receiving from the reverse mortgage, and may also unjust denials, leaving older adults with limited be left without a permanent place to live. 14 options for recourse without strong advocacy to Loss of Facilities Disrupts Continuity of Services. support them. Even with an advocate, litigation or The Eaton Canyon and Palisades fires destroyed a appeals may tie up compensation for years - a significant number of licensed Residential Care significant consideration for older adults. Facilities for the Elderly (RCFEs). These non- 15Older Adults with Reverse Mortgages Face Financial medical facilities provide residents with assistance Ruin When Losing a Home. Reverse mortgages allow with activities of daily living such as bathing, eating, homeowners to borrow against the equity in their mobility, and other basic tasks. The destruction of home. Unlike traditional loans, reverse mortgages RCFEs disrupts residents' access to services do not require monthly payments from the borrower. essential to their daily lives. A loss of services can Instead, the borrower receives a lump sum or lead to a decline in health, resulting in placement in monthly disbursements from their home equity with more restrictive institutional care. their home acting as the loan's collateral. The loss of RCFEs exacerbates shortages in long- The borrower does not need to begin payment on term care and strains the ability of residents to find the loan until the borrower dies, moves, fails to pay appropriate care. Fortunately, during the Eaton property taxes, or fails to carry homeowner's Fires, many residents of destroyed RCFEs were insurance - however, the loan continues to accrue relocated to a recently decommissioned Skilled interest during this period. When the homeowner Nursing Facility (SNF). There, they received dies, the inheritor of the home is responsible for temporary housing and assistance with daily living. 16 settling the loan balance either with their own However, continuity of care is still disrupted even if money, the proceeds from the sale of the home, or temporary housing and services are found quickly. by handing the home over to the lender. These 12 The full impact of the fires on medically fragile

California Commission on Aging 7

residents may only become clear after a thorough Behavioral Health Challenges May Intensify analysis of the health outcomes of displaced During Recovery. Multiple studies have shown that assisted living residents. cognitive decline is significantly accelerated by the trauma and dislocation caused by major disasters. 20 Temporary Changes Can Lead to Interruption of Immediate disaster response and recovery efforts Long-Term Care Services. Even residents of generally focus on promoting physical stability and undamaged facilities can have their lives drastically health, even when cognitive issues become disrupted by temporary transfers. Administrative apparent. complications and confusion between facilities can lead to inadequate care for those admitted to skilled A recent disaster can exacerbate existing behavioral nursing. One long-term care ombudsman shared health problems. Older adults dealing with that a resident evacuated to an equivalent skilled depression, anxiety, or other behavioral health nursing facility during the Eaton fires. At the new issues may experience worsening symptoms if they facility, the resident did not receive prescribed lose their home, a loved one, their community, or physical therapy due to the inability to share medical are overwhelmed by the stress of a traumatic event. records. The resident developed a new injury and These challenges should be understood in was informed, within 48 hours of returning to their conjunction with the ongoing "loneliness epidemic" original facility, that their Medicare coverage days disproportionately affecting older adults. had been expended. Mutual Aid Plans Can Strengthen Long-Term Care In other cases, temporary evacuation can lead to Disaster Response. Many long-term care facilities facilities implementing changes that disrupt a have mutual aid agreements with other facilities resident's routine or their sense of independence. that allow for sharing resources and information in Accounts from residents indicate that some facilities an emergency. When evacuations are necessary, reorganized facility grounds and units and removed facilities may share capacity with member mutual property from residents. Residents returned from aid facilities that need to relocate residents. evacuation facilities to find that their personal In California, mutual aid plans are fragmented property had been rearranged, stored, or removed between different networks of long-term care from the premises. 17 centers with no centralized state resource Older Adults Face Difficulty Replacing Durable facilitating agreements. As a result, many long-term Medical Equipment (DME). Many older adults care facilities either have no mutual aid agreement affected by the fires lost essential mobility or have an agreement with a memorandum of equipment such as wheelchairs, walkers, or understanding (MOU) that has not been maintained. Consequently, a facility's capacity to respond to scooters. Others lost critical medical devices, including oxygen concentrators, infusion pumps, disasters can be largely dependent on its ability to diabetes supplies, and other DME. form partnerships with other facilities. 18 21 Medicare will cover the replacement of DME that is Other states have implemented centralized mutual lost in a declared emergency. However, the aid plans with resounding success, such as equipment must be obtained through a Medicare- Massachusetts's MassMAP, which is considered a approved supplier. This requirement can pose a model for a successful long-term care mutual aid 19 serious challenge for older adults and people with plan. 22 disabilities, especially if the suppliers in the area are also impacted by the disaster.

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Disaster Related Scams Often Target Older Adults. difficult to rebuild solely using funds from insurance. Disaster recovery is rife with bad actors exploiting Generally, this means that the new structure will confusing and stressful situations. Many scams emphasize cost-efficient design over accessible design. target the rebuilding process and residents' eagerness to return to normal life. While the common areas of multifamily housing In the aftermath of the LA fires, unlicensed projects are required to be accessible, the units in contractors went door-to-door, claiming to be sent by those buildings are generally required to adhere to the residents' insurance companies to perform the lower standard of accessibility outlined in the repairs to fire-damaged homes. The scam Fair Housing Act Design Manual. The contractors pressured residents to sign predatory ccomprehensive accessibility standards outlined in documents or provide a large upfront fee. Residents the ADA are only required for multifamily housing eventually discovered the contractors were not sent projects that receive government funding or are by their insurance companies, and that they were publicly owned. 24 personally liable for any work completed. 23 Preparing for the Future Disaster areas are often so inundated with As recovery continues, the long-term effects of fraudulent activities that public enforcement and the Los Angeles fires on older adults remain prosecution of laws designed to stop these tactics uncertain. Insights from past disasters and are outpaced by the culprits. Mitigating efforts focus ongoing analyses can help guide planning to more on creating awareness of scams and meet their future needs. preventing individuals from falling prey. Older Adults May Be Disproportionately Affected by Older Adults Often Lack Access to Legal Resources. Widespread Loss of Housing. The state's housing The many challenges of rebuilding, navigating shortage is already putting pressure on older insurance, and dodging scams require public Californians. Since 2017, the number of unhoused education and advocates, including those with legal individuals aged 65 and over has grown faster than expertise. Older adults with limited resources or any other age group. The destruction of homes in without family support are in an especially 25 the LA fires will further restrict affordable housing precarious position. Without professional availability, which will likely disproportionately assistance, these individuals may not be able to impact older adults. negotiate higher claim payments from their insurance or ensure they are being treated fairly by The town of Paradise provides insight as to potential building contractors. Local advocacy organizations outcomes for older adults dislocated by the Eaton provide free legal assistance, but resources are and Palisades fires. Prior to the Camp Fire in 2018, limited. older adults made up one-quarter of the 26,000 residents of Paradise. After the Camp Fire, much of Infrastructure Rebuilt After Disaster Frequently the older adult population was displaced to other Lacks Accessible Design. In most cases, multifamily parts of the state and country. Today, Paradise has housing units are not required to be Americans with rebuilt only 25% of the homes lost. The older adult Disability Act (ADA) accessible. There is little population, once synonymous with the town, now incentive for housing developers to ensure that numbers approximately 1,000 individuals over the apartment buildings are accessible or are built with age of 65 out of about 8,000 total residents. universal design principles. As with single-family 26 homes, multifamily housing lost in a fire will be

California Commission on Aging 9

Similar displacement may occur in Altadena and contacted each other to assist by sharing housing and resources. During the recovery process, other areas of Los Angeles affected by the fires. Surrounding cities in the region will need to plan for members and volunteers coordinated assistance in displaced residents, particularly older adults, who navigating insurance, collecting donations, and offering direct emotional support. require not only affordable housing, but also 28 assisted living and skilled nursing services. Villages are an example of community organizations Emerging Environmental Concerns Create New that can be enlisted in emergency response. Challenges. There is growing evidence that even Pasadena Village is currently working to expand homes that were spared from complete destruction access to emergency kits and to offer preparedness may present environmental danger to residents. workshops for its members and other older adults. 29 Preliminary tests of homes with limited fire or smoke The close proximity of local Villages to their damage show traces of cyanide and carcinogens like members is a strength that can be leveraged in formaldehyde, asbestos, acetaldehyde, and others emergency preparedness. in homes with little apparent damage. 27 Agencies Are Unlikely Prepared for Other Disasters. Recent focus in emergency planning has been on Environmental issues have profound effects on those with weakened immune systems, particularly wildfires, but another type of disaster, such as a older adults and those with disabilities. Older adults major earthquake, may create different challenges whose homes survived the fires may suffer adverse for emergency services. Further study must be done health effects from contamination. Environmental to understand the impact that different disasters concerns exacerbate community housing have on older adults and people with disabilities. challenges. As of today, residents remain in flux, balancing safety risks with the need for housing. Community Led Organizations Create Networks that Support Recovery. Many organizations create local networks that enhance resiliency for vulnerable or marginalized populations. While these organizations are not strictly focused on emergency planning, they provide invaluable connections between older adults and people with disabilities with resources in times of crisis. For instance, the Village Movement California (Villages) is a community model that is heavily involved in disaster preparedness and response through member-driven empowerment. Villages are membership organizations comprised of older adults who share resources and support to enable independent aging. Pasadena Village facilitated communication between members and volunteers and provided essential assistance to members in Altadena and Pasadena impacted by the fire. At the outbreak of the Easton fire, members

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Recommendations

Local Administrative Actions Additionally, local organizations often have specific

details about clients they serve that can aid in Counties, cities, and local organizations should disaster response. The Village Movement California take steps to strengthen emergency resilience is one example of an organization that can provide in their communities. critical information on older adults in an affected area. These types of organizations can be an Pre-Designate Sites for Emergency important resource, particularly in the recovery Evacuation Centers in Emergency Plans process. Lead Entity: County Emergency Management

Ensure Older Adult Representation on Agencies

Planning Boards Local emergency plans are required to address how they ensure designated evacuation centers are Lead Entities: City Councils, County Boards of compliant with ADA. However, there is no Supervisors 30 requirement in statute that sites be pre-designated Local planning boards and commissions play a in the local agency's emergency plan. While some major role in the rebuilding process, particularly in emergency plans pre-designate sites, it is not a larger projects. It is important for these entities to uniform requirement in the law. consider the needs of older adults. As communities Local emergency management agencies must rebuild, planning authorities should emphasize identify sites for emergency evacuation centers that urban design that is accessible to all. Including older can accommodate people with access and adults and people with disabilities on these councils functional needs -- before a disaster. This means and boards helps ensure that newly constructed ensuring identified sites are ADA-compliant, have housing and infrastructure are not exclusionary. electrical capacity to handle a large base of State Administrative Actions evacuees with DME, and are in an area readily

State departments and agencies should use accessible by medical personnel.

their authority to make changes that do not Coordinate With Local Aging & Disability require new state or federal legislation. Organizations on Disaster Response Explore the Establishment of a Disaster

Lead Entity: Local Emergency Management Registry Departments Lead Entity: California Health and Human Services City and county emergency management Agency (CalHHS) departments need to coordinate with AAAs and Independent Living Centers (ILCs) when disasters California should explore developing a disaster occur. These agencies are the local experts on the registry that utilizes available data to provide first needs of older adults and people with disabilities. responders and emergency staff with more They must be included in emergency operations. information on affected residents of a disaster with specialized needs.

California Commission on Aging 11

Development of a state registry is contingent on Other states have created registries for older adults and people with disabilities so that first responders significant input from stakeholders in the aging and and staff at emergency shelters are aware of disability communities to ensure it doesn't injure the communities it aims to serve. individuals living within an evacuation zone. These registries are voluntary and therefore do not provide

Launch CA Department of Justice Task a complete listing of the entire population. States

Force on Disaster Recovery Scams that have developed disaster registries have found that information is often incomplete or inaccurate as Lead Entity: California Department of Justice current information on participants is difficult to maintain. The California Department of Justice must address 31 scams involving illegal contractor tactics, fraudulent Additionally, registries may provide a false sense of charities, and other activities that target older adults security. Registered individuals may assume that recovering from disasters. they will be prioritized in an emergency and do not have to prepare or evacuate their home when a The Attorney General launched a disaster relief task disaster strikes. Registries are designed to provide force in January primarily aimed at targeting price information and data to emergency staff, they are gouging in the immediate aftermath of the Eaton not a guarantee of rescue assistance. and Palisades fires. While important for combating 32 unscrupulous business practices, the task force did The state should examine ways to avoid typical not focus specifically on illegal activity perpetrated pitfalls of disaster registries, particularly regarding against those engaged in the rebuilding process, data accuracy. The state should consider using particularly older adults. publicly available and regularly updated data to avoid relying on individuals to update their records The Attorney General should create a task force or personally opt in. Developers of the registry could charged with investigating ongoing fraudulent partner with health plans and public service activities that target older adults, increasing local providers, such as county In-Home Supportive enforcement against such scams, and identifying Service (IHSS) programs, the California Department legal loopholes that prohibit prosecution of these of Social Services (CDSS) Adult Programs Division, crimes. the Department of Health Care Access and

Reestablish a Disaster Recovery Housing Information (HCAI), and the Department of Health

Aid Program Care Services (DHCS) to integrate available data into a comprehensive consortium. Lead Entity: Department of Housing and Community Development The need for privacy and data control must be weighed against efficiency. Developing a registry In 2020 and 2021, the RecoverCA Housing Program requires navigating complex considerations of aided eligible low-income homeowners with up to health data privacy and compliance with the Health $500,000 to rebuild homes lost or severely Insurance Portability and Accountability Act (HIPAA). damaged in fires. The program received funding 33 Individuals must be informed of their right to refuse from the federal Department of Housing and Urban to participate, and data should be obtained only with Development as part of the congressionally their express consent. Additionally, measures must appropriated Community Development Block Grant- be implemented to ensure data security. Disaster Recovery. 34

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Reestablishment of this program is contingent on Establish a State Long-Term Care Mutual Congress and the federal administration's allocation Aid System of funds to California. Without federal funds, Action: Statutory and Fiscal Change California must independently identify a source of funding to ensure low-income homeowners, Budget: Initial One-Time Funding/Ongoing especially older adults, have the resources to Appropriation rebuild. State Stakeholders: CalHHS, Cal OES

Amplify Access and Functional Needs Massachusetts, New York, and other states have Emergency Training established statewide systems that facilitate long- term care facilities in sharing resources during Lead Entity: California Governor's Office of disasters. The Massachusetts Long Term Mutual Aid Emergency Services (Cal OES) Plan (MassMAP) is considered a model of a state- The California Specialized Training Institute (CSTI) coordinated disaster response and recovery system provides emergency training to state and local for long-term care. government agencies, tribal organizations, non- California needs to establish a similar system to profits, and other organizations. CSTI is designed to allow the state to act as a facilitator in sharing provide specialized training for all levels of expertise information and resources. The state legislature in areas from emergency management to hazardous could authorize and fund CalHHS, Cal OES, and material handling. CSTI has designed a course on other state entities to contract with a partner who integrating access and functional needs into has experience establishing mutual aid plan emergency management. However, CSTI does not 35 systems. The state should invest in developing an appear to offer this course, or others specializing in interface that long-term care facilities could utilize to access and functional needs populations, with access and share information during disasters. regularity. 36 A uniform, accessible, long-term care mutual aid Emergency responders, local government agencies, system would be instrumental in ensuring that non-profit organizations, and businesses in the facilities with open capacity or available staff could aging and disability sector need access to training lend support to facilities in need during that highlights the specialized needs of older adults emergencies. It would also create a centralized and people with disabilities. Given the impact system, benefitting long-term care facilities with wildfires have on these communities, Cal OES must mutual aid agreements that are not regularly promote training for access and functional needs maintained and rely on out-of-date MOUs. emergency integration and make it readily available. A state mutual aid program would not just aid Legislative Actions facilities during large-scale natural disasters. It The California Legislature can provide local would provide a safety net when facilities experience governments and organizations with resources localized emergencies or experience higher-than- to support older adults and people with usual demand. The development of a state mutual

disabilities in recovery and assist in preparation aid program is not just an emergency preparedness

for future disasters. measure but an investment in the future of the state's long-term care system.

California Commission on Aging 13

The Federal Emergency Management Agency (FEMA) Provide Disaster Preparedness Funds to provides free legal services to low-income AAAs and Independent Living Centers individuals affected by a federally declared disaster. Action: Fiscal Change Assistance is limited to cases that typically do not involve attorney fees, including help with insurance Budget: Ongoing Funding claims, home repair contracts, and FEMA appeals. 38 State Stakeholders: California Department of Aging AAAs provide referral to similar legal services for (CDA), Cal OES, California Department of older adults as part of their normal operations, Rehabilitation funded through the OAA. However, funding and the 39 availability of legal services are limited during AAAs are the primary source of local aging services disasters, as legal support services are strained by in the state. They are a valuable tool in providing increased workloads. information and resources directly to older adults. Services provided by AAAs are generally funded by The legislature should develop a state legal services the federal government through the Older Americans fund to aid local organizations that provide legal Act (OAA), with each AAA receiving funds through an representation in response to disasters. The fund intrastate funding formula. The state is required to could be administered by the Cal OES and would provide matching funds to AAAs to receive federal only be made available during a major disaster funding for specific services. 37 declared by the Governor. There has been no effort to appropriate funds to A one-time appropriation by the Legislature would be AAAs specifically for disaster preparedness and required to establish such a fund, with successive resiliency efforts. Federal guidance waived certain appropriations made as needed. requirements and created additional flexibilities for AAAs to use existing OAA funds during the COVID-19 Require Reverse Mortgage Servicers to pandemic, but it did not fund disaster resilience. Provide Counseling Referrals The state legislature needs to appropriate General Action: Statutory Change Fund for use by AAAs for disaster preparedness and Budget: None resilience. AAAs can ensure that their clients are prepared for a disaster by distributing emergency The Housing and Urban Development Act of 1968 kits and supporting the creation of individual directs HUD to provide grants to organizations emergency plans. Funding can also help ensure offering housing counseling services to homeowners AAAs create an emergency infrastructure that is and tenants. Reverse mortgage lenders are 40 responsive during a disaster. required by law to provide prospective borrowers with a list of no less than 10 HUD-approved Develop a State Disaster Legal Services counseling agencies. These agencies provide

Fund reverse mortgage counseling before finalizing the application. The lender cannot accept a complete Action: Statutory and Fiscal Change application until the borrower has completed Budget: One-Time/Upon Appropriation by the counseling. 41 Legislature The legislature should require reverse mortgage State Stakeholders: Cal OES servicers (the companies that manage the loan after it's made) to provide disaster-affected borrowers

14 California Commission on Aging

with a list of HUD-approved counseling agencies to learned from past disasters, and fostering ensure access to impartial guidance. Many older collaboration with local emergency officials. Clear, adults lack resources for legal advocacy. Federally actionable disaster plans are especially critical in funded housing counselors can help them navigate long-term care facilities, where vulnerable residents complex processes such as reverse mortgage need extra support. By establishing accountability procedures. Without this information, borrowers may for SNF operators, the bill aims to reduce chaos rely solely on their loan servicer or lender instead of during evacuations and emergency responses in receiving the independent advice needed to make future disasters. informed decisions after a disaster.

Efforts In Progress

CCoA supports these ongoing legislative efforts to strengthen disaster planning and resiliency for older adults. Assembly Bill 1069: Emergency services available during natural disasters

AB 1069, authored by Assemblymember Jasmeet Bains, requires the agency responsible for emergency sheltering duties to coordinate an MOU with either the local AAA or an Aging and Disability Resource Connection program to ensure that either organization can access emergency evacuation shelters. 42 As the population of older adults in California continues to increase, AAAs must be tapped as a resource during emergencies. Beyond the intent of this bill, CCoA maintains that AAAs and ILCs be fully integrated into emergency planning to ensure those with access and functional needs are not overlooked.

Senate Bill 582: Health and care facilities: licensing during emergencies or disasters

SB 582, authored by Senator Henry Stern, requires SNFs to annually review their external disaster and mass casualty plans and seek input from county, regional, and local planning offices, including the medical health operational area coordinator. 43 The bill strengthens disaster planning for SNFs by promoting best practices, encouraging lessons

California Commission on Aging 15

Notes

Note: Data was compiled by CCoA staff using public Dr. Laura Mosqueda, Professor of Family Medicine and 1 10 database from the Los Angeles County Medical Geriatrics, Keck School of Medicine of USC. Testimony to Examiner's Office. CCoA. May 22, 2025. CNN. "A Father At The Bedside Of His Son, A Surfer Dr. Laura Trejo, Director, Los Angeles County Aging 2 11 And A Woman Who Stayed Behind With Her Beloved and Disabilities Department. Testimony to CCoA. May 22, Pets Are Among Wildfire Victims." January 24, 2025. 2025. https://www.cnn.com/2025/01/11/us/california-wildfires- Ibid. 12 victims Federal Trade Commission. Consumer Advice. 13 Terry Castleman, Salvador Hernandez, Matthew 3 https://consumer.ftc.gov/articles/reverse-mortgages Ormseth, and Grace Toohey. "12 Hours Of Fire That Bertha Sanchez Hayden, Associate Vice President, Bet Decimated Altadena." Los Angeles Times. January 18, 14 Tzedek Legal Services. Testimony to CCoA. May 22, 2025. https://www.latimes.com/california/story/2025-01-

1. 17/chaotic-first-hours-eaton-fire-timeline-maps Note: Data on damaged/destroyed long-term care Ally J. Levine, Clare Farley, Tiana McGee, and Daisy 15 4 facilities was provided to CCoA staff by Rachel Tate. Chung. "Fast Fires." Reuters. January 24, 2025. https://www.reuters.com/graphics/CALIFORNIA- Rachel Tate, Vice President, Ombudsman Services, 16 WILDFIRE/SPEED/akpeewrodpr/ WISE & Healthy Aging. Testimony to CCoA. May 22, 2025. Sue Anne Bell, Dianne Singer, Erica Solway, Mattias 5 Kirch, Jeffrey Kullgren, and Preeti Malani. "Predictors of Rachel Tate, Vice President, Ombudsman Services, 17 Emergency Preparedness among Older Adults in the WISE & Healthy Aging. Written testimony to CCoA. United States." Disaster Med Public Health Prep, Vol. 15, Received May 19, 2025. Issue 5 (October 2021): 624-630. TJ Hill, Executive Director, Disability Community https://doi.org/10.1017/dmp.2020.80 18 Resource Center. Written testimony to CCoA. Received Keith Mizuguchi. "Despite Three 911 Calls, Two 6 May 12, 2025. Homebound Disabled Men Died In Eaton Fire." KQED. Center for Medicare & Medicaid Services. "Durable July 21, 2025. 19 Medical Equipment, Prosthetics, Orthotics, and Supplies https://www.kqed.org/news/12048956/despite-three-911- for Medicare Beneficiaries Impacted by an Emergency or calls-two-homebound-disabled-men-died-in-eaton-fire Disaster." Fact Sheet. Dr. Laura Mosqueda, Professor of Family Medicine and 7 https://www.cms.gov/files/document/dmepos-emergency- Geriatrics, Keck School of Medicine of USC. Testimony to or-disaster-fact-sheet-ogc-and-ccpg-approvedpdf CCoA. May 22, 2025. Jacob Thompson, Maryam Vasefi. "Natural disaster-20 Dr. Laura Mosqueda, Professor of Family Medicine and 8 induced dementia and cognitive decline: A meta-analysis Geriatrics, Keck School of Medicine of USC. Testimony to and systematic review." Social Science & Medicine, Vol. CCoA. May 22, 2025. 371 (April 2025). https://doi.org/10.1016/j.socscimed.2025.117898 Aaron Schrank. "Nursing Home Evacuees Faced Cot 9 Shortages In Pasadena, Medical Staff Say." LAist. John Burke, Corporate Safety Officer, Human Good. 21 https://laist.com/news/nursing-home-cot-shortages-Testimony to CCoA. May 22, 2025. pasadena-eaton-fire John Burke, Corporate Safety Officer, Human Good. 22 Written testimony to CCoA. Received May 19, 2025.

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16, 2025. https://oag.ca.gov/news/press- releases/attorney-general-bonta-opens-price-gouging- Bertha Sanchez Hayden, Associate Vice President, Bet investigations-deploys-doj-disaster 23 Tzedek Legal Services. Written testimony to CCoA. Note: Eligibility and program policies are listed in the 33 Received May 20, 2025. Department of Housing and Community Development's Note: A full explanation of the applicable laws and ReCoverCA Housing Programs Policies and Procedures. 24 design standards required for different housing types is The 2020 handbook is available on the HCD website: provided by the Division of the State Architect. https://www.hcd.ca.gov/sites/default/files/docs/grants- and-funding/recoverca/recoverca-oor-pnp-2020.pdf Division of the State Architect. Guide to Public Housing Regulated by Chapter 11B of the California Building Housing and Community Development Act of 1974, 34 Code. https://www.dgs.ca.gov/- Title I. 42 U.S.C. 5301 et seq. /media/Divisions/DSA/Publications/access/ch11B/DSA California Specialized Training Institute. "Integrating 35 PublicHousingGuidance.pdf Access & Functional Needs Into Emergency Management." Training Course Flyer. Cal OES. Note: This is based on data compiled through the 25 https://www.caloes.ca.gov/wp-Homeless Data Integration System provided by the content/uploads/AFN/Documents/General/G197-Course-California Interagency Council on Homelessness. Flyer-2024.pdf https://www.bcsh.ca.gov/calich/hdis.html Note: CCoA staff based this finding on the list of 36 Joseph Cobery, Executive Director, Passages Area 26 courses in the CSTI Training Bulletin No. 10-2025. Agency on Aging. Written testimony to CCoA. Received May 14, 2025. Note: The Older Americans Act lists the full 37 requirements for receiving federal funds for aging Blacki Migliozzi, Rukmini Callimachi and K.K. Rebecca. 27 services (42. U.S.C. 3021 et seq). A draft of the California "'Unsafe to Inhabit': The Toxic Homes of L.A." The New Older Americans Act State Plan with a list of core York Times. June 24, 2025. programs to be provided by AAAs can be found on the https://www.nytimes.com/interactive/2025/06/24/realestat California Department of Aging's website. e/los-angeles-fires-toxic-homes.html https://aging.ca.gov/oaa_state_plan/ Katie Brandon, Executive Director, Pasadena Village. 28 Federal Emergency Management Agency. "Disaster 38 Written testimony to CCoA. Received May 13, 2025. Legal Services." Fact Sheet. January 21, 2025. Katie Brandon, Executive Director, Pasadena Village. 29 https://www.fema.gov/fact-sheet/disaster-legal-services Testimony to CCoA. May 22, 2025. California Department of Aging. "Supportive Services 39 California Government Code, Section 8593.3(a)(3) 30 Program Older Americans Act Title III B." Program Narrative. March 2020. Miranda Green. "Los Angeles Weighs A Disaster 31 Registry. Disability Advocates Warn Against False Title 24 Code of Federal Regulations Part 214 et seq. 40 Assurances." CBS News. California Civil Code, Section 1923.2(j) 41 https://www.cbsnews.com/news/los-angeles-weighs- disaster-registry-disability-advocates/ Assembly Bill 1069 (Bains). 2025. 42 Office of the Attorney General. "Attorney General Bonta 32 Senate Bill 582 (Stern). 2025. 43 Opens Price Gouging Investigations, Deploys DOJ Disaster Relief Task Force in Southern California." California Department of Justice. Press Release. January

California Commission on Aging 17

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California Commission on Aging 2880 Gateway Oaks Drive, Suite 390, Sacramento, CA 95833 HOUSING THOSE HARDEST HIT: Addressing Older Adult Homelessness916.419.7591 | ccoa@ccoa.ca.gov | www.ccoa.ca.gov