Access & Functional Needs: Zero to Full Competency

Why This Addendum Exists

Chapter 8 tells you what to have and do at each tier of a disruption for a household member with access or functional needs. It does not build the actual caregiving and equipment-management competency that makes those plans real rather than aspirational, especially the “named backup caregiver” Chapter 8’s Tier 1 calls for. This addendum is a skill-building curriculum for exactly that, built from real certifications and training, not just planning checklists.

It’s organized by skill stage, not by disaster duration, following the same structure as the other addenda. As with Addendum A, treat this as general skill-building guidance: the specific care needs of any household member should still come from their own doctor, DME supplier, or care team, not from this addendum.

Four stages: Foundations (basic safe practice), Applied Practice (hands-on competence), Self-Sufficiency (independent, resilient skill), and Mastery & Teaching (able to teach others and operate at community scale). Each stage covers two sub-skill tracks that run in parallel: caregiving, and medical equipment/device management.

Stage 1: Foundations (Awareness)

Goal: know the core safety facts well enough to help without causing injury (to the person you’re helping or yourself), and understand your household’s specific equipment landscape. This stage is readable in a weekend.

Caregiving: Core Knowledge

The core concept at this stage is body mechanics: most caregiver back injuries happen from lifting or transferring someone incorrectly, using the back instead of the legs, twisting while lifting, or attempting a transfer alone that genuinely needs two people. Understand the CMIST framework already covered in Chapter 8 (Communication, Medical care, Independence, Supervision, Transportation), since it’s the actual planning model Utah’s public health system uses, and it gives structure to what “access and functional needs” actually covers beyond mobility alone.

Medical Equipment: Core Knowledge

The core concept at this stage is knowing your household’s specific devices well enough to answer basic questions without searching: exact power draw in watts, battery backup duration, and the manufacturer’s own emergency guidance (not generic advice). Chapter 8’s equipment-specific notes on CPAP, oxygen, and dialysis are the floor, not the ceiling, of what you should know if your household actually depends on one of these.

Stage 1 Learning Path

Stage 1 Practice Exercises

• Document your household’s exact device specs: Write down the exact power draw, battery backup time, and manufacturer emergency contact for every powered medical device in your household.

• Learn the CMIST framework well enough to apply it: Walk through your own household’s plan against all five CMIST categories, not just mobility, since Communication and Supervision needs are easy to overlook.

• Watch (don’t yet perform) a proper transfer technique: Find manufacturer or PT-produced video guidance on proper transfer technique for your household’s specific equipment (wheelchair, hospital bed) before attempting it yourself.

Stage 2: Applied Practice (Competent)

Goal: move from knowing the theory to having actually practiced caregiving physical skills under real instruction, and have a real, willing backup caregiver in place, not just a name on paper.

Caregiving: Applied Practice

• Take the Red Cross Family Caregiving course: Covers home safety, infection control, medication safety, reading and recording vital signs, and general elder/dependent-care skills; available in classroom and self-study formats through local Red Cross chapters.

• Practice a real transfer with instruction: Under supervision (a home health aide, PT, or the care recipient’s own care team), physically practice the specific transfer technique your household actually needs, not a generic one.

• Formalize your named backup caregiver: Chapter 8’s Tier 1 calls for a named backup caregiver; Stage 2 is where that person actually sits down with you, learns the specific care routine hands-on, and confirms in writing they’re willing and able.

Medical Equipment: Applied Practice

• Run a real backup-power test for every device: Actually run each powered medical device on its backup power source (battery, power station) for its full rated duration at least once, not just assume the rating is accurate. See the Backup Power for Medical Equipment & Caregiving skill guide for device-specific sizing and runtime planning.

• Practice basic troubleshooting for your specific devices: Learn your device’s common failure points and basic fixes (a clogged CPAP filter, a low-battery warning sequence) directly from the manufacturer’s manual.

• Confirm utility priority reconnection registration: If not already done from Chapter 8’s Tier 1, actually complete your electric utility’s medical equipment priority reconnection registration rather than just knowing it exists.

Stage 2 Learning Path

Stage 3: Self-Sufficiency (Proficient)

Goal: genuine independent caregiving and equipment-management competency, the actual skill level Chapter 8’s Tier 2 and Tier 3 assume a household has. This stage involves real, substantial coursework.

Caregiving: Self-Sufficiency

• Complete Certified Nursing Assistant (CNA) training: Utah CNA programs run roughly 76–100 hours combining classroom, online, and hands-on clinical instruction, offered through Utah Tech University and multiple other providers statewide, leading to registration on the Utah Nursing Assistant Registry. This is a genuinely professional-level caregiving credential, not just an awareness course.

• Train a second backup caregiver: One backup caregiver is a single point of failure; Stage 3 is where a second person also learns the specific care routine, so illness or unavailability of the first backup doesn’t leave the household without support.

• Understand your household’s specific condition in real depth: Beyond general caregiving skill, build real working knowledge of the specific condition(s) in your household (from the person’s own care team), since generic caregiving competency and condition-specific competency are different skills.

Medical Equipment: Self-Sufficiency

• Build real device-repair competency for your specific equipment: Go beyond basic troubleshooting to understanding your device’s actual internals (filters, tubing, connectors, common failure points) well enough to keep it running longer without professional service.

• Understand DME supply chain alternatives: Research and identify at least one backup DME supplier or equivalent device model, since Chapter 8’s Tier 3 assumes the normal supply chain may not be available.

• Cross-train with Addendum D (Energy & Heat): A household’s device backup-power plan is only as good as the underlying electrical competency behind it; Addendum D’s Self-Sufficiency stage is directly relevant here.

Stage 3 Learning Path

Stage 4: Mastery & Teaching (Expert)

Goal: professional-level credentials, the ability to train others, and real community-scale capability. This is the stage Chapter 8’s Tier 4 (distributed caregiving, community wellness checks) actually depends on.

Teaching & Certification

• Pursue Certified DME Specialist (CDME) credential: A national certification (via the Board of Certification/Accreditation) for durable medical equipment repair, troubleshooting, and home inspection, covering oxygen equipment, transfer systems, enteral feeding supplies, and wound care equipment; requires a high school diploma or equivalent plus a minimum of 500 hours of relevant experience. This is the genuine professional ceiling for the equipment track in this addendum.

• Train additional caregivers beyond your own household: Chapter 8’s Tier 4 explicitly calls for distributed caregiving across the community, not just within one household; Stage 4 is where you teach the transfer techniques and care routines you’ve mastered to neighbors, not just your own backup caregivers.

• Volunteer with DSPD or a related organization: Beyond personal certification, active volunteer involvement with Utah DSPD or a similar organization builds real community-scale caregiving capacity and connects you to people who may need a trained backup caregiver.

Community-Scale Practice

• Build the wellness-check system described in Chapter 8’s Tier 4: Chapter 8 calls for a structured, regular wellness-check system for isolated or high-need community members; Stage 4 is where you help design and run it, not just list it as a goal.

• Build a shared adaptive equipment cache: Chapter 8’s Tier 4 calls for a community-level stock of spare mobility aids and adaptive tools; your Stage 3/4 device competency is exactly what makes a shared cache actually usable rather than a pile of unmaintained equipment. The DIY Assistive Equipment Fabrication skill guide covers building or modifying adaptive equipment when a replacement isn’t available at all.

• Ensure community planning is genuinely inclusive from the start: Chapter 8’s guidance on accessible community shelter design and inclusive planning depends on people with real AFN caregiving competency being involved in community-level disaster planning directly, not consulted after the fact.

Stage 4 Learning Path

A Suggested Learning Sequence

The two tracks (caregiving, medical equipment) don’t have to move at the same pace, and the relevant depth depends heavily on your household’s actual needs. As a rough guide, not a requirement:

• Weeks 1–2: Stage 1: document your household’s exact device specs, learn the CMIST framework, watch proper transfer technique guidance.

• 1–4 months: Stage 2: complete Red Cross Family Caregiving, practice real transfers with instruction, formalize and train your named backup caregiver.

• 6–12 months: Stage 3: complete or enroll in CNA certification, train a second backup caregiver, build real device troubleshooting competency.

• Ongoing: Stage 4: pursue CDME certification if equipment work is becoming a real focus, train caregivers beyond your household, and help build your neighborhood’s wellness-check system.

At a Glance: Access & Functional Needs Deep Dive

A single-page reference for planning purposes. This does not replace the detailed guidance above; use it to see how the four stages scale, and cross-reference against Chapter 8’s tiers, which describe what a household needs to have and do rather than how skilled it needs to be.