Special Needs Registry (RC Version: 9.13.3.0)

Special Needs Registry

What is the special needs registry?

The Special needs registry is a tool being developed for use by St Clair County that enables emergency responders to locate and service those with special needs. This partnership will allow first responders to know of any special needs persons and what their needs are in their area. This then allows your first responders to prioritize their response during emergency situations. This program will help meet the needs of persons who could need assistance during evacuations and sheltering because they are elderly, physically, mentally, sensory disabled, visually or hearing impaired, require oxygen, or other challenges.

Once collected, officials will plot all of the residents with challenges on a map layer and note their special needs. If a disaster happens, the County will be able to readily identify individuals who are registered.

You may be initially contacted to verify the information that you submitted and occasionally there after to verify if the information is still current.

Who are people with special needs?

The population is made up of people who are vulnerable, at risk, or hard to reach and will require specialized communications and/or transportation during and emergency.

In an effort to identify residents with special needs in the event of an emergency, St Clair County Emergency Management has developed a form to distribute to residents to build a special needs registry.

In the event of a disaster or the potential for a disaster the information that you provide in this application may be used to:
• establish contact with you to assess your situation and provide you with information you may need in order to prepare for or respond to a disaster;

• direct you toward the facility or shelter which is most suited to meet your needs in the event you are unable to remain home, or to make other arrangements for your care and safety;

• assist emergency services personnel and volunteers in providing services.

All of the information submitted will be confidential, and will be used by first responders. Residents who have special needs or challenges should fill out the form, available on the County Website. This form may be filled out and submitted on line or printed out and mailed to the address on the form.

Special Needs Form

Disclaimer

The Special Needs Registry is a cooperative public safety program in St. Clair County. It is designed to ensure the safety of those residents of St. Clair County that are most vulnerable to emergencies and disasters, the elderly and infirmed and those with various disabilities. The information you provide about your health and medical conditions may be shared with the Health Department, Police, Fire and other emergency workers to assist them in responding to a disaster or emergency. You may revoke your consent to sharing information at any time by sending a written request to: St. Clair County Emergency Management Agency, 110 West Washington Street, Belleville, IL 62220. "Providing this information does not insure that emergency responders will be able to provide services to you in an emergency but will assist them in responding appropriately based on available resources." By submitting this information, you consent to sharing information on this form. I certify that the information provided on this form is correct. I understand that I am responsible for all expenses associated with medical evacuation and shelter at a hospital, nursing facility or for any specialized equipment needed in a special needs shelter. Furthermore, I hereby grant permission to the St. Clair County Office of Emergency Management to release this information to other emergency response or human service agencies or officials. Additionally, I give local law enforcement and/or medical personnel permission to enter my home in case of an emergency. It is my responsibility to update the information on this form as needed. Please mail this completed form to the address above. You may also email it the address listed above.