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for their planning. This information may not accurately determine evacuation times. A coordinated traffic count and accurate time study must be done to provide objective data. Our plan does not consider all the anxiety associated with evacuation, such as separation of family members, doomsday thoughts, and the loss of normalcy. Our assumptions do not consider traffic jams, roadwork, vehicle crashes, or weather conditions. The plan does not consider any attempts of families to reunite before evacuating. Actions such as parents rushing to schools, employees leaving work to meet their families, or people going home to collect pets must be considered. Does your plan consider calculating evacuation times based on realistic scenarios? Do you consider roadwork, normal traffic congestion, and school or business schedules? Do you have a current traffic flow time study? Have you considered adverse citizen reactions? Do you allow for family reunification prior to evacuating? All regional planning initiatives must be coordinated to avoid duplication of efforts and prevent overlooking important factors. The development of regional planning initiatives should include efforts to determine the best routes for travel, direct evacuees around traffic bottlenecks, and promote cooperation among agencies for multiple jurisdictions. The regional effort must develop coordinated sheltering plans that provide assistance for evacuees, including pets. Plans must include the segment of the population who has special needs. Planning strategies must use realistic and tested or theoretically sound assumptions. Every county has citizens who are unable to easily move about, be totally independent, or communicate easily. Emergency management typically considers these individuals as having special needs. We have few resources available to evacuate citizens with special needs. There are a limited number of ambulances, buses, and wheelchair capable transports. Further, we have limited capability to inform, assist, and warn non-English speaking residents and visitors. It is difficult to quickly and efficiently evacuate institutions in the counties and region. The types of institutions are varied and diverse including universities and schools, hospitals, jails and prisons, animal shelters, daycare, assisted living, and nursing homes, just to name a few. Patient care levels may be difficult or impossible to maintain due to the number of patients. For example, many patients are dependent upon infusion pumps, ventilators, and other electrically operated medical devices. In addition, an average of 135 patients receive outpatient dialysis treatment daily at just three dialysis units in Orange and Durham Counties. Our plan allows for citizens to remain inside their respective facilities in a practice known as 'sheltering in place'. This may, depending on the incident, preclude the need for an evacuation. Successful sheltering in place requires extensive procedural education to the general public and is useful in limited circumstances. Our plan assumes transportation will be available for all the patients with special needs. However, many facilities have contracted with the same transportation providers. While this is effective in normal circumstances, it presents problems in incidents requiring evacuation. For example, three rest homes contract with a transport provider, which is included in their transportation evacuation plans. The transport provider may not be able to provide enough units and staff to effectively evacuate all three facilities simultaneously. We assume all personnel will be available and remain at their jobs. While many workers will be able to come to work, some will not. We assume that all patients will be healthy enough to move. However, many will not feasibly be moved because of dependency on medical devices, frailty, and/or specialized medical treatments. Does your plan consider how sufficient transportation resources for citizens with special needs will be provided? Does your plan assume all personnel will come to work, or allow for the fact that personnel can be victims too and may not be able to come to work? Does your plan consider that some citizens may not be healthy enough to survive the evacuation process? Does your plan address the ability to transport, maintain, and use medical equipment necessary for special needs evacuees? Regional planning efforts should identify the locations of special needs facilities. Regional planning should determine existing resources and identify gaps. Only after the capabilities of the region have been identified are we able to address shortcomings. Regional