Slowly absorbing the lessons of Hurricane Katrina in the Gulf Coast, Hawai'i likely will make emergency shelters more accessible to elderly and disabled people and reserve some shelters for people who need extensive medical care.

State and community officials have been talking since September about how to help people with special needs in a disaster after Civil Defense officials acknowledged that no shelter in the state has been identified for the elderly or disabled. State House lawmakers at an informational briefing yesterday were told that as many as 240,000 people in the Islands may have special needs.

Ruth Stepputtis, a retired preschool operator who lives alone in Waimanalo, said the state could be better prepared. She said she drives and takes the bus, so she believes she could get to a shelter if she had to evacuate, but she sees how she might need some consideration.

"I'm still agile. But, sometimes, I have a little trouble keeping up," she said.

Chuck Fleming, a retired government worker on the Big Island who uses a wheelchair, said many disabled people may have trouble getting to shelters and worry about whether facilities, such as restrooms, will be accessible.

"People with disabilities do have some real concerns," he said.

The lack of provisions for the elderly and disabled could lead to chaos and tragedy after a disaster. Toby Clairmont, the emergency program manager for the Healthcare Association of Hawaii, who led a medical assistance team into New Orleans after Katrina, said some patients were taped to doors or office partitions and transported to safety in trucks because traditional equipment was unavailable. News accounts described some elderly people who were trapped in their homes or in nursing homes and left to die.

"We can't afford to have that happen in Hawai'i," Clairmont said.

The state has identified thousands of adults and children in licensed-care facilities who might need assistance, but has moved away from any attempt to build a registry, given the challenges of keeping the list up-to-date or giving people a false sense that they would be rescued. It would be particularly difficult to find all the people who live alone at home or who care for a sick family member.

Francine Wai, executive director of the Disability and Communication Access Board, said it would be a mistake for the state to try to separate the elderly and disabled from other people at shelters unless they have certain medical needs.

Advocates want special shelters for people needing medical care, since hospitals, which may have to handle up to 500 casualties after a catastrophic storm, are not designed as shelters.

"I think we've made a lot of progress in getting people to accept that all shelters need to be accessible," Wai said. "We cannot plan for them in isolation."

The state has estimated it is 124,000 spaces short of its overall goal of having 462,000 shelter spaces available in emergency. Civil defense officials have said it would take $35 million and several years to upgrade shelters, most of which are located at public schools. Officials likely will ask the state Legislature for $4 million next session.

State Rep. Ken Ito, D-48th (Kane'ohe), chairman of the House Public Safety and Military Affairs Committee, said lawmakers likely will support shelter improvements.

"We don't want to keep the money in the bank and then regret later that we didn't do anything," Ito said.

Ed Teixeira, vice director of state Civil Defense, said the state would direct money to make shelters more accessible for people with special needs. He said he would also request tax incentives to encourage nursing homes and other care facilities to retrofit so people might not have to evacuate.

State Rep. Kameo Tanaka, D-10th (W. Maui), asked Teixeira at the briefing to rate the state's preparedness on a scale of 1 to 10. Teixeira gave the state a 5.

"We've got a lot of work to do and I'm not ashamed to say it," Teixeira said.

Reach Derrick DePledge at ddepledge@honoluluadvertiser.com.