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Populations with Access and Functional Needs
Topic Collection
March 28, 2025

Topic Collection: Populations with Access and Functional Needs

During a disaster, individuals with disabilities and others with access and functional needs will require special assistance from the emergency management system. Planning before an incident ensures that response and recovery operations are inclusive of the whole community and that these populations do not suffer disproportionate impact. Please note that ASPR TRACIE recently published a Topic Collection (TC) on Disasters and At-Risk Populations that may provide significant additional information.

The resources in this Topic Collection highlight recent case studies, lessons learned, tools, and promising practices for working with individuals with disabilities and other populations with access and functional needs. ASPR TRACIE updated this Topic Collection in June 2022.

Additional resources for at-risk populations can be found in the following TCs: Pediatrics, Dialysis Centers, Long-term Care Facilities, Homecare and Hospice, and Pharmacy.

Please also note:

•   For the purposes of this Topic Collection, we respectfully use the term “Access and Functional Needs,” however, we acknowledge that there are many other terms that are frequently used such as at-risk, special needs, and vulnerable populations. Using these various terms do not negate the usefulness of these resources, which provide valuable planning concepts and ideas for inclusion of the whole community.

•   Due to the changing dynamics of disability and access and functional needs policy, guidance, and regulations, there are some documents that are not yet updated with the most current changes. However, they are included here as foundational documents that users should be aware of.

Each resource in this Topic Collection is placed into one or more of the following categories (click on the category name to be taken directly to that set of resources). Resources marked with an asterisk (*) appear in more than one category.

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Must Reads

American College of Emergency Physicians. (n.d.). Planning Considerations for Persons with Access and Functional Needs in a Disaster. (Accessed 6/2/2022.)
This resource includes all papers in a 3-part series developed by the American College of Emergency Physicians focused on planning considerations for persons with access and functional needs in a disaster. Part one identifies who is included in this population and reviews related disaster legal considerations; part 2 discusses evacuation and sheltering and the CMIST (communication, medical needs, independence, supervision, and transportation) framework, with a focus on mental health; and part 3 highlights the medical aspect of CMIST, with care recommendations for individuals at increased risk during a disaster.
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ASPR TRACIE. (2021). Durable Medical Equipment in Disasters.
This ASPR TRACIE tip sheet provides information on general durable medical equipment (DME) categories and focuses on electricity-dependent DME that may be affected by disasters and emergencies, including power failures. It also includes information to assist healthcare system preparedness stakeholders plan for populations who rely on DME.
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Federal Emergency Management Agency. (2010). Guidance on Planning for Integration of Functional Needs Support Services in General Population Shelters.
This guidance document redefines the requirements for inclusion in general population shelters and provides new direction for the approach formerly known as “special needs shelters.” This document describes the national standard for shelter operations that integrate people with disabilities and others with access and functional needs into general population shelters.
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Florida Department of Health. (2014). Continuum of Care Model: Caring for Elders during Disasters: A Guide for Community-Based Planning.
The purpose of this project was to provide information and resources to guide and support local communities in their efforts to develop and sustain a continuum of care for older adults during disasters. This document provides a comprehensive guide to communities for engaging older adult care stakeholders in the preparedness, response, and recovery cycles of all-hazards disaster management.
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Levine, C. (2019). Introducing the Capacity Building Toolkit for Including Aging and Disability Networks in Disaster Planning.
In this PowerPoint, the speaker discusses the role of the Office of the Assistant Secretary for Preparedness and Response in preparing Americans and people with access and functional needs for disasters.
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National Council on Disability. (2009). Effective Emergency Management: Making Improvements for Communities and People with Disabilities.
This report to the President includes recommendations to all levels of government for developing policies, programs, and practices across the disaster life cycle (preparedness, response, recovery, and mitigation) specific to people with disabilities. It includes examples and evaluation of effective community efforts.
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U.S. Department of Veterans Affairs, the U.S. Department of Health and Human Services, and the U.S. Department of Housing and Urban Development. (2017). Disaster Preparedness to Promote Community Resilience: Information and Tools for Homeless Service Providers and Disaster Professionals.
This toolkit includes information that can help emergency and public health officials, homeless service providers, and healthcare providers work together to plan for the disaster needs of people experiencing homelessness in their communities. It is separated into three sections: Creating an Inclusive Emergency Management System, Guidance for Homeless Service Providers: Planning for Service Continuity, and Guidance for Health Care Providers.
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Education and Training

Centers for Disease Control and Prevention. (2018). Addressing the Needs of People with Disabilities in Public Health Emergencies.
This webinar discusses “how community leaders, community members, emergency response workers, and caretakers can plan ahead to lessen the harm of emergencies on people with disabilities.”
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Centers for Medicare & Medicaid Services. (2022). Replacing DME & Prescription Drugs after a Disaster: Addressing the Needs of Medicare Beneficiaries. U.S. Department of Health and Human Services.
This training discusses access to durable medical equipment and prescription drugs after a disaster. It provides information on prescription drug programs through Medicare during recovery and contact information for the Centers for Medicare & Medicaid Services. In the description, it also contains links to current Medicare information since policies can change. The full report is also available: https://www.cms.gov/files/document/replacing-dme-and-prescription-drugs-after-disaster-student-manual.pdf
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Federal Emergency Management Agency. (2016). IS-505: Religious and Cultural Literacy and Competency in Disaster.
The course provides emergency management professionals and faith and community leaders active in disaster with the religious literacy and competency tools needed to learn how to effectively engage religious and cultural groups and their leaders throughout the disaster lifecycle.
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Kailes, J.I. (2020). Training: Maximizing Your ROI. The Partnership for Inclusive Disaster Strategies.
This training aims to help emergency planners apply recent lessons learned to protect the lives of people with disabilities, access, and functional needs by keeping training up to date. This includes refreshing training materials often, conducting disaster preparedness exercises, interval learning, and using evaluation methods.
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Levine, C. (2019). Introducing the Capacity Building Toolkit for Including Aging and Disability Networks in Disaster Planning.
In this PowerPoint, the speaker discusses the role of the Office of the Assistant Secretary for Preparedness and Response in preparing Americans and people with access and functional needs for disasters.
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Louisiana State University Health Sciences Center, School of Nursing. (2012). C3DC: Cornerstone of Cultural Competency during the Disaster Cycle.
The intended audience for this training is registered nurses who want to learn techniques to manage both the physical and psychological impacts of disasters on populations such as older adults, with disabilities, children, and people experiencing homelessness.
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Mountain Plains Regional Disaster Health Response System. (2024). Just-in-Time Learning Series.
This webpage provides links to various recordings healthcare providers can use "just in time" to treat patients who have been exposed to a variety of threats (e.g., biological, radiological, and chemical agents) or who may be practicing outside of their area of expertise in a medical surge event. Subject matter experts present on a diverse range of topics relevant to disaster preparedness and response in these 15-30 minutes modules. Considerations are also made for treating special populations (e.g., older patients and pregnant patients) in a disaster setting.
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National Association of County and City Health Officials and Association of State and Territorial Health Officials. (2019). Capacity-Building Toolkit for including Aging & Disability Networks in Emergency Planning. Office of the Assistant Secretary for Preparedness and Response, U.S. Department of Health and Human Services.
This toolkit was designed to help the aging and disability networks expand their ability to plan for and respond to public health emergencies and disasters. It is comprised of nine modules grouped under two sections: Readiness Assessments and Emergency Planning and Working in Tandem with Consumers.
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Natural Hazards Center. (2019). CONVERGE Training Modules. (Free registration required.)
The Natural Hazards Center is developing these modules "to advance social science and interdisciplinary extreme events research efforts through identifying, mapping, and training a diverse group of researchers." Two modules are currently available: Social Vulnerability and Disasters and Disaster Mental Health.
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* New Jersey Office of Emergency Management (2015). Disaster Planning Templates for Facilities Housing Individuals with Functional Needs, Elderly or Frail Elderly.
This website offers a collection of templates and training courses for facilities responsible for housing those with access or functional needs.
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* Office of Minority Health. (2013). Cultural Competency Curriculum for Disaster Preparedness and Crisis Response. U.S. Department of Health and Human Services.
This set of courses is designed to integrate knowledge, attitudes, and skills related to cultural competency to help lessen racial and ethnic healthcare disparities brought on by disaster situations.
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Ohio State University. (2015). Disability Training for Emergency Planners: Serving People with Disabilities.
This is an hour-long training for first responders and emergency planners on inclusive disaster planning for people with disabilities. It provides “information and best practices that will ensure the safety of people with disabilities during emergency events.”
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Pacific ADA Center. (2021). Archived Inclusive Emergency Management Webinars.
This webpage includes links to over 50 webinars focused on emergency planning for individuals with disabilities dating from current back to 2012 including incident-based lessons learned, best practices, health policy, and inclusive EM planning in the community.
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ReadySanDiego. (n.d.). First Responder Access and Functional Needs Training Series. (Accessed 6/2/2022.)
This series of 8 short training videos was produced by the County of San Diego Office of Emergency Services. While created for first responders, the information in these videos on interacting with individuals with access and functional needs may be helpful to public health planners and healthcare personnel.
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Roszak, A. and Hershey, T. (2019). Approach the Bench – Preparing Judges for Disasters & Emergencies.
In this 28-minute podcast, the speakers discuss the importance of enhancing legal preparedness capacity before disasters, with a focus on sovereign tribal nations and the differences in tribal vs. state laws and relation to federal laws.
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* U.S. Department of Health and Human Services, Office for Civil Rights (2011). Avoiding Disasters for the “Special Needs Population”: Effective Planning, Response, and Recovery for the Special Needs Population, Consistent with Federal Civil Rights Laws.
This slide deck from the Office for Civil Rights focuses on three specific populations: persons with disabilities, persons from diverse ethnic/racial origins, and those with limited English proficiency. It includes guidance on providing disaster services within the scope of federal civil rights laws.
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U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response. (2019). HHS emPOWER Program Web-Based Training. (Free account required.)
The HHS emPOWER Program Web-Based Training is a free, publicly accessible course designed to help partners better understand the HHS emPOWER Program and integrate its tools into their emergency preparedness, mitigation, response, and recovery.
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U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response. (2020). HHS/ASPR: Access and Functional Needs.
The HHS/ASPR Access and Functional Needs (AFN) web-based training defines the concept and requirements for addressing people with disabilities, and provides tools and resources to help professionals incorporated related concepts into disaster preparedness, response, and recovery activities.
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U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response. (2022). HHS emPOWER Map.
This interactive map shows the number of Medicare beneficiaries who are electricity-dependent in a state, territory, county, or ZIP Code. The data can be used to plan, respond, and recover from electricity outages and other disasters in specific geographic regions.
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General Guidance and Research

American College of Emergency Physicians. (n.d.). Planning Considerations for Persons with Access and Functional Needs in a Disaster. (Accessed 6/2/2022.)
This resource includes all papers in a 3-part series developed by the American College of Emergency Physicians focused on planning considerations for persons with access and functional needs in a disaster. Part one identifies who is included in this population and reviews related disaster legal considerations; part 2 discusses evacuation and sheltering and the CMIST (communication, medical needs, independence, supervision, and transportation) framework, with a focus on mental health; and part 3 highlights the medical aspect of CMIST, with care recommendations for individuals at increased risk during a disaster.
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ASPR TRACIE. (2021). Durable Medical Equipment in Disasters.
This ASPR TRACIE tip sheet provides information on general durable medical equipment (DME) categories and focuses on electricity-dependent DME that may be affected by disasters and emergencies, including power failures. It also includes information to assist healthcare system preparedness stakeholders plan for populations who rely on DME.
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* Casey-Lockyer, M. and Myers, S. (2019). ADA (Americans with Disabilities Act) National Network Learning Session: The Latest in American Red Cross Efforts to Integrate People with Disabilities in Emergency Planning and Response.
Speakers outline the American Red Cross Disability Integration, highlighting current disaster relief operational successes (e.g., video relay phone installations and sensory kit distribution) and challenges that arise during relief operations. The webinar also features best practices, such as daily stakeholder calls and state disability integration coordinators, that can help emergency planners develop and update existing plans.
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Centers for Disease Control and Prevention. (2016). Emergency Preparedness and Disability Inclusion.
This webpage features links to resources specific to including people with disabilities in emergency planning and preparedness. The resources are divided into two categories: state disability and health programs and federal agencies.
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* Centers for Disease Control and Prevention (2022). Before, During, and After an Emergency.
Parents, teachers, doctors and nurses are just some of the people who can help children get ready for and cope with disasters. Parents, schools, and childcare centers can prepare so that children can be as safe as possible during and after a disaster. These comprehensive resources help the whole community address the unique needs of children in disasters.
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Centers for Disease Control and Prevention, Office of Public Health Preparedness and Response (2010). Public Health Workbook to Define, Locate, and Reach Special, Vulnerable, and At-risk Populations in an Emergency.
This federal guidance document is designed to provide public health and healthcare system practitioners with practical guidance to plan for the unique needs of individuals with access and functional needs during disasters.
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Commonwealth of Massachusetts, Department of Public Health, Office of Preparedness and Emergency Management. (2019). Access and Functional Needs Resource Guide.
This guide is a compilation of public health resources designed to assist with preparedness planning for individuals with access and functional needs.
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Cote, E., Peterson, L., Evans, A., and Nil, M. (2023). Advancing Preparedness for Life Support Users During Power Outages.
As power outages increase in frequency and duration, many people who depend on life support and other types of durable medical equipment will face challenges maintaining the power needed for their equipment. This report describes how a pilot project launched in July 2021 by the Louisiana Department of Health helped minimize risk to medical device users and reduced drain on hospitals, ambulance providers, and shelters during emergencies.
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Federal Emergency Management Agency. (2010). Guidance on Planning for Integration of Functional Needs Support Services in General Population Shelters.
This guidance document redefines the requirements for inclusion in general population shelters and provides new direction for the approach formerly known as “special needs shelters.” This document describes the national standard for shelter operations that integrate people with disabilities and others with access and functional needs into general population shelters.
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Federal Emergency Management Agency. (2014). IS-368: Including People with Disabilities & Others With Access & Functional Needs in Disaster Operations.
This two-hour course aims to improve participants’ understanding of people with access and functional needs for disaster preparedness and response. It covers the importance of inclusion and support, the history, and the legal foundation of providing services to these community members.
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Federal Emergency Management Agency. (2017). Language Guidelines for Inclusive Emergency Management.
This resource “offers language guidelines when referring to people with disabilities, people who may be disproportionately impacted during a disaster, and other with access and functional needs.”
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Fritz Institute. (2006). Hurricane Katrina: Perceptions of the Affected.
This report presents a summary of findings from research conducted among adults affected by Hurricane Katrina who were living in Louisiana, Alabama or Mississippi before the storm hit. The surveyors assessed perceptions of those that received help during the first 48 hours and first 30 days after the storm hit.
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(n.d.). Functional Needs of People with Disabilities: A Guide for Emergency Managers, Planners and Responders.
This guide highlights key disability concerns for officials and experts responsible for emergency planning in their communities, and seeks to assist them in developing plans that will take into account the access and functional needs and insights of people with disabilities before, during, and after emergencies.
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Health Resources & Services Administration. (2021). Workforce Shortage Areas. U.S. Department of Health and Human Services.
This webpage includes links to information on workforce shortage (i.e., an "area, population, or facility experiencing a shortage of health care services"). It defines Health Professional Shortage Areas, Maternity Care Target Areas, and Medically Underserved Area/Populations and highlights how shortages affect specific facilities (e.g., rural health clinics, tribal hospitals, and federally qualified health centers.
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Kailes, J.I. (2012). Effectively Including People with Disabilities in Policy and Advisory Groups, Edition 2.
This resource provides guidance on building and sustaining an advisory board, council, or workgroup that includes people with disabilities in impactful ways. It discusses the importance of including people with disabilities to plan for themselves, and how to identify and recruit qualified individuals with disabilities to participate. A planning checklist for building and sustaining a planning group is included.
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Kailes, J.I. (2020). Defining Functional Needs - Updating CMIST. The Partnership for Inclusive Disaster Strategies.
This article examines the history of the CMIST framework, discusses how it can be updated among evolving terminology to maximize safety and support for individuals with disabilities, and access and functional needs. The article explains that emergency managers should optimize for function to meet these individuals’ needs.
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Kailes, J.I. (2021). Health Plan Member-Focused Emergency. World Institute on Disability.
This guide aims to integrate emergency preparedness into health plans to protect their members during emergencies and disasters.
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Kennedy, P. (2015). Advocacy for People with Speech Disabilities: Emergency Preparedness Resources. Therapy Times. 14:15.
This article discusses challenges and resources for people who have difficulty communicating as a result of pre-existing conditions such as cerebral palsy, autism, and cognitive delays. Communication techniques include speech generating devices, sign language, and picture communication displays.
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Litman, T. (2021). Evaluating Transportation Equity: Guidance for Incorporating Distributional. Victoria Transport Policy Institute.
This article describes equity analysis for transportation, including practical advice for transportation planning, equity types, metrics, and objectives.
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Los Angeles County Department of Public Health. (2017). Strategies for Inclusive Planning in Emergency Response.
This document can help those working in emergency management ensure that comprehensive planning includes people with access and functional needs (people with disabilities and other groups disproportionately impacted in emergencies). It includes templates, checklists, and other helpful resources.
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Marion County Sheriff's Office. (n.d.). Intermediate Care Facilities for the Developmentally Disabled. (Accessed 6/2/2022.)
This document from Marion County, FL provides general emergency management planning criteria for an ICF, to include topics such as legal authorities, hazard analysis, basic emergency operations and functions, and information and training for staff.
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Transportation Research Board. (2016). Paratransit Emergency Preparedness and Operations Handbook.
This handbook provides guidance to paratransit service providers for urban, suburban, rural, and tribal communities so that individuals with access and functional needs can access transportation during disasters and emergencies.
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U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response. (2023). Addressing the Access and Functional Needs of At-Risk Individuals.
This webpage defines at-risk populations and challenges individuals with access and functional needs may experience with accessing or receiving medical care before, during, or after a disaster or public health emergency. The CMIST (communication, medical needs, independence, supervision, and transportation) framework is also reviewed.
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U.S. Department of Justice, Civil Rights Division. (2007). Chapter 7: Emergency Management Under Title II of the ADA.
This chapter provides information on the Americans with Disabilities Act of 1990 and its implications for emergency management. It encompasses preparation for disasters, notification of an emergency, evacuation and transportation, sheltering during a disaster, access to services, and recovery after a disaster.
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Washington State Department of Social and Health Services. (n.d.). Information for ICFs/IID Providers. (Accessed 6/2/2022.)
This website provides links to information on ICFs to include a section on Emergency Preparedness.
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Wisconsin Department of Health Services. (2019). Functional Assessment Service Team (FAST).
This webpage provides information on Wisconsin’s Functional Assessment Service Team (FAST) model, created to support individuals with access and functional needs in community shelters during emergencies. It may be adapted by other jurisdictions for their mass sheltering plans.
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World Health Organization. (2013). Guidance Note on Disability and Emergency Risk Management for Health.
Together with several stakeholders, the World Health Organization produced this guide for emergency healthcare providers who may treat people with access and functional needs.
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Lessons Learned

Behr, J., Yusuf, W., Marshall, J. and Dunn, E. (2020). Workshop #1: Vulnerable Populations & Planning Considerations for the 2020 Hurricane Season: After Action Report (AAR). Old Dominion University.
This After-Action Report discusses the findings from a workshop that examined disaster preparation and people who live/work in settings that put them at increased/higher risk of becoming infected or exposed to hazards in the context of a compound hurricane-pandemic threat that requires the use of emergency shelters. The authors highlight how a pandemic requires identifying new shelter options, modifying procedures for screening and triage, and enforcing social distancing and other prevention methods in shelters and during transportation to shelters, all of which result in the need for additional staff.
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* Casey-Lockyer, M. and Myers, S. (2019). ADA (Americans with Disabilities Act) National Network Learning Session: The Latest in American Red Cross Efforts to Integrate People with Disabilities in Emergency Planning and Response.
Speakers outline the American Red Cross Disability Integration, highlighting current disaster relief operational successes (e.g., video relay phone installations and sensory kit distribution) and challenges that arise during relief operations. The webinar also features best practices, such as daily stakeholder calls and state disability integration coordinators, that can help emergency planners develop and update existing plans.
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Centers for Disease Control and Prevention. (2021). Access and Functional Needs Toolkit: Integrating a Community Partner Network to Inform Risk Communication Strategies. U.S Department of Health and Human Services.
This resource discusses communication planning for individuals with access and functional needs, as well as guidance for integrating community partners into communication strategies. It replaces CDC’s Public Health Workbook: To Define, Locate, and Reach Special, Vulnerable, and At-Risk Populations in an Emergency published in 2010.
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Gilbert, N., Savoia, E., Elqura, L., et al. (2009). Emergency Preparedness for Vulnerable Populations: People with Special Health-care Needs. Public Health Reports. 124: 338-343.
The authors describe a conceptual framework developed by participants of “Equity in Preparedness: A Collaborative Symposium for Populations with Special Health-Care Needs in Boston.” The framework addresses medical, communication, supervision, and transportation needs while maintaining functional independence.
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Guillaume, D. and Griffen, A. (2018). Inclusive Emergency Management Preparedness, Response, and Recovery. Association of University Centers on Disabilities.
This resource discusses lessons learned from 2018 disasters that impacted U.S. Territories, and policy recommendations for University Centers for Excellence in Developmental Disabilities Education, Research, and Service (UCEDDs), and Federal, State and Territorial governments. Specifically, it discusses the capabilities that UCEDDs have to support inclusive disaster preparedness, response, and recovery, how these capabilities were used effectively in the past, and how collaboration between UCEDDs and governmental authorities could be strengthened to improve outcomes for individuals with disabilities.
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Kailes, J.I. (2016). Be Real, Specific and Current: Emergency Preparedness Information for People with Disabilities and Others with Access and Functional Needs.
This resource offers guidance, examples, and resources on promoting or producing general emergency preparedness information for people with disabilities.
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Kailes, J.I. (2018). Planning Checklist for Rapid Emergency Response for Organizations Serving People with Disabilities, Edition 1.4.
This checklist aims to support the health of individuals with disabilities and access and functional needs during emergency response and recovery. It includes information on continuity of operations, community partnerships, and how to identify which services are available from local and state governments.
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Kailes, J.I. (2020). Guidance for Integrating People with Disabilities.
This guide describes how emergency managers can integrate participants with disabilities into disaster preparedness exercises, including finding qualified experts on disability, incorporating real actors with disabilities, and using a location that is accessible.
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Kailes, J.I. (2020). The National Shelter System and Physical Accessibility – Time to Look Under the Hood. The Partnership for Inclusive Disaster Strategies.
This article discusses the physical accessibility criteria used in shelters run by the American Red Cross based on informal discussions with the organization’s staff, and how emergency management professionals rely on the National Shelter System for physical accessibility information.
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Montana Disability and Health Program. (2016). Emergency Preparedness: An Inclusive Guide for People with Access and Functional Needs.
This is a strategic plan for the state of Montana to support health and medical partners in the development and implementation of inclusive emergency plans, and to “promote inclusive adapted emergency preparedness materials and training using a function-based approach” in collaboration with partners. It includes roles and responsibilities for partners, and specific ideas for ensuring that inclusive preparedness information reaches individuals with access and functional needs.
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Mountain Plains Regional Disaster Health Response System (MPRDHRS). (2023). Marshall Fire Learning Series: Regional Coordination.
This 1-hour video is part of a four-video series in which stakeholders who supported the emergency response to the December 31, 2021, Marshall Fire discuss regional coordination among public health, disaster management, and the local health care coalition. They discuss emergency sheltering, evacuating residents with access and functional needs, and local coordination structures.
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National Association of County & City Health Officials. (2016). Hurricane Sandy Recovery Workshop Summary Report: Lessons Learned and Promising Practices for Home and Community-Based Service Providers.
This document details findings and lessons learned from a review of the Hurricane Sandy response. The methods for the workshop are explained and the storm’s effect on utilities, communications, staffing, transportation, and emergency responders are explored.
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North Carolina Department of Public Safety. (n.d.). Access and Functional Needs Toolkit for Emergency Managers. (Accessed 6/21/2022)
This toolkit provides an overview of legal requirements, C-MIST, agreements and contracts, and the Americans with Disabilities Act. It also contains checklists for emergency planners regarding planning, training exercises, communications, transportation, evacuation, sheltering, and recovery.
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* Polen, K. and Ellington, S. (2018). Protecting Pregnant Women and Babies During Public Health Emergencies. Centers for Disease Control and Prevention, Office of Public Health Preparedness.
This webinar can help healthcare providers can learn more about the impact of public health emergencies like Zika and H1N1 on pregnant people and babies.
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Roth, M., Kailes, J.I., and Marshall, M. (2018). Getting It Wrong: An Indictment with a Blueprint for Getting It Right. The Partnership for Inclusive Disaster Strategies.
This After-Action Report describes the experience of children and adults with disabilities that were impacted by federally declared disasters from August 2017 through January 2018. The authors contend that lessons learned from prior disasters were not applied effectively by governmental authorities at all levels to ensure that individuals with disabilities have equal access to emergency programs and services before, during and after disasters.
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Schroeder, J. and Bouldin, E. (2019). Inclusive Public Health Preparedness Program to Promote Resilience in Rural Appalachia (2016–2018). American Journal of Public Health. 109(S4): S283-S285.
This article describes how the authors worked with communities and collaborative partners in rural Appalachia to develop an all-hazards inclusive emergency plan, and then tested it through tabletop and full-scale exercises.
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U.S. Department of Health and Human Services, Department of Homeland Security. (2019). Listening Sessions with Disability Stakeholders in Disaster Impacted Areas.
This webpage includes links to summaries from a series of listening sessions conducted by the Department of Homeland Security Office for Civil Rights and Civil Liberties and the Federal Emergency Management Agency. The purpose of these sessions was to identify concerns resulting from experiences related to the impact of disasters on individuals with disabilities in various geographic areas, as well as ways to support individuals with disabilities and others with access and functional needs.
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Plans, Tools, and Templates

* Administration for Strategic Preparedness and Response. (2021). HHS Maternal-Child Emergency Planning Toolkit. U.S. Department of Health and Human Services.
This toolkit outlines basic planning steps, highlights key resources and promising practices, and explains critical data and information to be integrated into emergency planning for maternal-child health populations. It provides guidance and advice to address the needs of people who are pregnant, postpartum, and/or lactating and typically developing infants and young children in emergencies.
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* Alzheimer’s Association and RTI International. (n.d.). Disaster Preparedness: Home and Community-Based Services for People with Dementia and Their Caregivers. (Accessed 6/2/2022.) University of New England.
This guide provides public health officials, the Aging Services Networks, emergency management personnel, and partners at all jurisdictional levels the critical information, strategies, and resources they need to improve the planning for and protection of older adults during emergencies. The toolkit includes lessons learned from model programs or unique examples, and key preparedness actions for states and caregivers.
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American College of Emergency Physicians. (2013). Disaster Planning Toolkit for the Elderly and Special Needs Persons.
This toolkit was designed to help older Americans and people with access and functional needs prepare for health-related post-disaster needs. It includes checklists and planning activities that can be downloaded, printed, and shared with caregivers and others.
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* Canopy Innovations. (2015). Canopy Medical Translator Overview.
This YouTube video describes the Canopy Medical Translator app which translates 1500 common medical phrases into 15 different languages, including Spanish, Chinese, Arabic and Russian. The phrases cover emergency medicine and other fields.
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* Centers for Disease Control and Prevention. (2007). Reproductive Health Assessment Toolkit for Conflict-Affected Women.
This toolkit can be used to quantitatively assess reproductive health risks, services, and outcomes in conflict-affected women between 15 and 49 years of age. Survey data can be used to compare a population across points in time or to make comparisons across populations.
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City of New York, Department of Health and Mental Hygiene. (2020). Heat Wave Preparedness Checklists for Vulnerable Population Service Providers.
These checklists can help healthcare and other service providers identify residents at highest risk for heat-related illnesses.
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Florida Department of Health. (n.d.). Special Needs Shelter Program. (Accessed 5/16/2025.)
This website includes an overview of Florida’s special needs shelters (SpNS) program, operating procedures and guidelines, forms (e.g., intake forms, job action sheets, sign-in sheets, etc.), activation reports and guidelines, and trainings.
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Georgia State Government, ADA Coordinator's Office. (2014). State of Georgia Functional and Access Needs Support Services Toolkit.
This toolkit provides local officials with the means to plan and provide reasonable accommodations for all residents during disaster incidents. The toolkit addresses general emergency planning considerations and also shelter considerations. Chapter 4 addresses medical needs, durable medical equipment considerations, chronic medication issues, and other considerations for individuals with access and functional needs. Though developed for the State of Georgia, it can be utilized by other jurisdictions.
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HHS emPOWER Program. (2024). HHS emPOWER Map.
The HHS emPOWER Map provides a monthly, updated de-identified total at the national, state, territory, county, and ZIP Code levels for Medicare beneficiaries currently enrolled in the Centers for Medicare and Medicaid Services (CMS) Medicare Fee-For-Service (Parts A/B) or Medicare Advantage (Part C). The map also provides a monthly updated total for the number of Medicare beneficiaries who have had an administrative claim for one or more types of electricity-dependent durable medical and assistive equipment (DME) and devices, as well as at-risk combinations data for those who rely on a health care service(s) and any electricity-dependent DME and devices.
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Illinois Department of Public Health. (2019). Illinois Department of Public Health ESF-8 Plan: Functional and Access Needs (FAN)/At Risk Populations Annex.
This state plan is designed to help stakeholders address the needs of residents with functional and access needs in a disaster.
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Meredith, L., Shugarman, L., Chandra, A., et al. (2008). Analysis of Risk Communication Strategies and Approaches with At-Risk Populations to Enhance Emergency Preparedness, Response, and Recovery. RAND Health.
This assessment is intended to inform planning for risk communication regarding public health emergency preparedness, response, and recovery for individuals with access and functional needs.
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Minnesota Department of Public Safety. (2015). Functional Needs Planning Toolkit for Emergency Planners.
This toolkit provides state-level guidance to local governments on creating and implementing plans that are inclusive for those with access or functional needs.
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* New Jersey Office of Emergency Management (2015). Disaster Planning Templates for Facilities Housing Individuals with Functional Needs, Elderly or Frail Elderly.
This website offers a collection of templates and training courses for facilities responsible for housing those with access or functional needs.
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Ringel, J., Chandra, A., Williams, M., et al. (2010). Enhancing Public Health Emergency Preparedness for Special Needs Populations: A Toolkit for State and Local Planning and Response. Public Health Preparedness within RAND Health.
The authors share the most relevant strategies, practices, and resources from a range of sources (e.g., peer-reviewed research and government reports) to identify "priority populations" and strategies for addressing their public health emergency needs.
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* U.S. Department of Health and Human Services, Office for Civil Rights (2011). Avoiding Disasters for the “Special Needs Population”: Effective Planning, Response, and Recovery for the Special Needs Population, Consistent with Federal Civil Rights Laws.
This slide deck from the Office for Civil Rights focuses on three specific populations: persons with disabilities, persons from diverse ethnic/racial origins, and those with limited English proficiency. It includes guidance on providing disaster services within the scope of federal civil rights laws.
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U.S. Food and Drug Administration. (n.d.). Home Use Devices: How to Prepare for and Handle Power Outages for Medical Devices that Require Electricity. (Accessed 6/2/2022.)
This booklet can help those who use electrically-powered medical devices plan for and respond to power outages.
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Population-Specific Resources: Children

American Academy of Pediatrics. (2013). Pediatric Preparedness Resource Kit.
This resource kit was designed to address issues that occurred during 2009 H1N1 planning and allows for pediatricians, public health leaders, and other pediatric care providers to assess what is already happening in their community or state, and help determine what needs to be done before an emergency or disaster. It promotes collaborative discussions and decision making about pediatric preparedness planning at the local and state level and encourages integration of pediatric providers into disaster planning. It also contains a link to the Joint Policy Statement—Guidelines for Care of Children in the Emergency Department, as well as a Preparedness Checklist for Pediatric Practices and guidance for prioritizing vaccination during pandemics.
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American Academy of Pediatrics, Needle, S. and Wright, J. (2015). Ensuring the Health of Children in Disasters. 136(5): e1407-e1417.
This policy statement addresses how pediatricians and others involved in the care and well-being of children can prepare for and mitigate the effects of disasters, encourage preparedness and resiliency among children and families and within communities, and ensure that children’s needs, including those of children and youth with special healthcare needs, are not neglected in planning, response, and recovery efforts.
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Bagwell, H.B., Liggin, R., and Thompson, T. (2016). Disaster Preparedness in Families With Children With Special Health Care Needs. (Abstract only.) Clinical Pediatrics.
The authors assessed the impact of a disaster supply starter kit intervention on preparedness for families of children with special healthcare needs. They found that families who received the kit improved their preparedness, as evidenced by a significant increase in the presence of an Emergency Information Form and disaster kit.
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* Centers for Disease Control and Prevention (2022). Before, During, and After an Emergency.
Parents, teachers, doctors and nurses are just some of the people who can help children get ready for and cope with disasters. Parents, schools, and childcare centers can prepare so that children can be as safe as possible during and after a disaster. These comprehensive resources help the whole community address the unique needs of children in disasters.
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Chin, K., Tan, P., Simmons, T., et al. (2020). A Mixed-Method Analysis: Disaster Preparedness of Families with Children with Access and Functional Needs. (Free registration required) American Journal of Disaster Medicine 15(3):187-197.
This small study evaluated “challenges to disaster preparedness of families with children with access and functional needs (CAFN),” and found that preparedness among these families is low, as evidenced by a lack of disaster kits, medical plans for children, and written communications plans. The authors recommend that parents, schools, healthcare providers, and communities collaborate to improve preparedness in CAFN.
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Disaster and Community Crisis Center, University of Missouri. (2016). Disasters and Child Abuse: A Fact Sheet for Disaster Responders and Providers. University of Missouri Disaster and Community Crisis Center.
This fact sheet can help disaster responders understand the potential connections between disasters and child abuse or neglect. Links to related resources and strategies responders can use before, during, and after a disaster are included.
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Emergency Medical Services for Children Innovation and Improvement Center. (2022). Disaster and Families of Children with Disabilities: What Every Health Care Provider Needs to Know.
The materials highlighted in this video and webpage can be used to help on-board healthcare providers and during emergency management exercises to ensure that they and families of children with disabilities are "disaster ready."
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Federal Emergency Management Agency. (2017). Keeping Children Safe after Hurricane Harvey.
This fact sheet (available in a variety of languages) can help parents and caregivers keep children safe and feeling calm after a disaster. While specific to 2017's Hurricane Harvey, the fact sheet can be used for any type of major disaster.
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Federal Emergency Management Agency and The American Red Cross. (2004). Helping Children Cope with Disaster.
This document includes tips for parents, caregivers, and other adults regarding helping children cope with the effects of disaster. It also includes information on preparedness.
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National Academies of Sciences, Engineering, and Medicine. (2018). Opportunities for Improving Programs and Services for Children with Disabilities. The National Academies Press.
Research shows that a growing number of children have at least one chronic health condition. This report provides an overview of programs, services, and supports (and related program, service, and treatment goals) available to these children and their families. The authors also share what has been learned about the effectiveness of these programs and services.
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National Child Traumatic Stress Network. (n.d.). Childhood Traumatic Grief Resources for Parents and Caregivers. (Accessed 6/2/2022.)
This webpage contains links to resources that parents and caregivers can use to help children and teenagers through the aftermath of a disaster.
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Stough, L. and McAdams Ducy, E. (2019). Evacuating Under Fire: Children with Special Healthcare Needs in Disaster. Natural Hazards Center, University of Colorado.
This article highlights challenges faced by children with special health care needs in the event of evacuations or shelter in place orders. The authors briefly cover lessons learned and promising practices and provide links to tools for caregivers and planners at the end.
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Transportation Research Board. (2016). Communication with Vulnerable Populations: A Transportation and Emergency Management Toolkit.
This toolkit details how to communicate with populations with access and functional needs during an emergency about their transportation options. It focuses on scalable and adaptable communications drawing from public, private, and nonprofit agencies, and how these agencies can coordinate during emergencies.
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U.S. Department of Agriculture, Food and Nutrition Service. (2022). Food Safety Emergency Response Pocket Guide.
This guide provides information for school nutrition professionals during natural disasters and emergencies. It can be used during incidents such as power outages, floods, fires, and water contamination to train before, during, and after an emergency.
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U.S. Department of Health and Human Services, Administration for Children and Families, Youth and Families, Family and Youth Services Bureau. (2009). Ready for Anything: A Disaster Planning Manual for Runaway and Homeless Youth Programs.
This document is designed to help staff at youth-serving agencies construct a successful emergency preparedness plan. It includes worksheets and checklists to guide staff step-by-step through the process of creating an emergency preparedness plan for their agency.
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U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response. (2018). Hurricane Response – Resources for Children with Special Health Care Needs.
The resources on this ASPR webpage can help families, organizations, and clinicians who provide care to children with special healthcare needs in hurricane-affected areas. Links are provided under these categories: General Resources; CSHCN Specific Resources; Trauma-Informed Care and Mental Health Support; Family Support & Health Financing; and Resources for Clinical Providers.
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U.S. Government Accountability Office. (2013). National Preparedness: Efforts to Address the Medical Needs of Children in a Chemical, Biological, Radiological, or Nuclear Incident.
The U.S. Government Accountability Office was asked about efforts to address the needs of children in the event of a CBRN (chemical, biological, radiological, and nuclear) incident. This report examines (1) the percentage of CBRN medical countermeasures in the Strategic National Stockpile that are approved for pediatric use; (2) the challenges the U.S. Department of Health and Human Services (HHS) faces in developing and acquiring CBRN medical countermeasures for the pediatric population, and the steps it is taking to address them; and (3) the ways that HHS has addressed the dispensing of pediatric medical countermeasures in its emergency response plans and guidance, and ways that state and local governments have addressed this issue.
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Population-Specific Resources: Cultural and Linguistic Diversity

* Canopy Innovations. (2015). Canopy Medical Translator Overview.
This YouTube video describes the Canopy Medical Translator app which translates 1500 common medical phrases into 15 different languages, including Spanish, Chinese, Arabic and Russian. The phrases cover emergency medicine and other fields.
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Health Outreach Partners and Migrant Health Promotion. (2015). Including Outreach Workers and Community Health Workers in Health Center Emergency Preparedness and Management.
This tip sheet focuses on how outreach workers can support basic emergency management expectations for health centers, including emergency management planning, linkages and collaborations, and communication and information sharing.
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National Consensus Panel on Emergency Preparedness and Cultural Diversity. (2011). Guidance for Integrating Culturally Diverse Communities into Planning for and Responding to Emergencies: A Toolkit. American Hospital Association.
This toolkit was developed to provide preparedness planning and response agencies, organizations, and professionals with practical strategies, resources and examples of models for improving existing activities and developing new programs to meet the needs of racially and ethnically diverse populations.
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Office of Minority Health. (n.d.). Ensuring Culturally and Linguistically Appropriate Crisis Communication. (Accessed 7/7/2022) U.S. Department of Health and Human Services.
The guide lays out best practices for cultural inclusion when designing crisis communications. It includes information on understanding the demographics of the area being served, engaging community members, and setting a respectful and open tone to encourage understanding.
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* Office of Minority Health. (2013). Cultural Competency Curriculum for Disaster Preparedness and Crisis Response. U.S. Department of Health and Human Services.
This set of courses is designed to integrate knowledge, attitudes, and skills related to cultural competency to help lessen racial and ethnic healthcare disparities brought on by disaster situations.
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Office of Refugee Resettlement. (2023). Emergency Preparedness Booklet. U.S. Department of Health and Human Services, Administration for Children and Families.
These booklets (available in more than 10 languages) were created to teach refugees about the types of disasters that occur in the U.S. and related preparedness and response steps.
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The National Disaster Interfaiths Network (NDIN) and the USC Center for Religious & Civic Culture. (2014). Field Guide Primer: Religious Literacy Primer for Crises, Disasters and Public Health Emergencies.
This field guide provides information on basic religious literacy for more than 20 of the largest faith communities in the United States and can help assist healthcare emergency managers understandhow faith communities and emergency management intersect.
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U.S. Department of Health and Human Services, Administration for Strategic Preparedness and Response. (2023). Cultural and Linguistic Competency for Disaster Preparedness Planning and Crisis Response.
This webpage includes links to resources and tools that enhance and address cultural and linguistic competency to help mitigate the impact of disasters and emergency events.
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Population-Specific Resources: Maternal-Child Health and Gender Issues

* Administration for Strategic Preparedness and Response. (2021). HHS Maternal-Child Emergency Planning Toolkit. U.S. Department of Health and Human Services.
This toolkit outlines basic planning steps, highlights key resources and promising practices, and explains critical data and information to be integrated into emergency planning for maternal-child health populations. It provides guidance and advice to address the needs of people who are pregnant, postpartum, and/or lactating and typically developing infants and young children in emergencies.
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American College of Obstetricians and Gynecologists' Committee on Obstetric Patients. (2017). Hospital Disaster Preparedness for Obstetricians and Facilities Providing Maternity Care. ACOG Committee Opinion. 726.
This opinion paper lists recommendations hospitals that provide maternity services should consider in the development of their disaster plans, including to have a pediatric co-director for maternity services disaster planning, and maternity and pediatric nursing represented on the committee.
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Bucio, G.O. (2011). Helping Latin-American Immigrant Pregnant Women Exposed to Trauma: Reflections on Mirroring.
The author explains mirroring (how babies "see" themselves in their mothers' faces) and how it is impacted by trauma. She also shares lessons learned from personal experience that can be applied to women seeking help after a disaster.
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* Centers for Disease Control and Prevention. (2007). Reproductive Health Assessment Toolkit for Conflict-Affected Women.
This toolkit can be used to quantitatively assess reproductive health risks, services, and outcomes in conflict-affected women between 15 and 49 years of age. Survey data can be used to compare a population across points in time or to make comparisons across populations.
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Centers for Disease Control and Prevention. (2014). Health Indicators for Disaster-Affected Pregnant Women, Postpartum Women, and Infants.
This guide provides health assessment and surveillance techniques for disaster-affected pregnant and postpartum people and infants by using common epidemiologic indicators to affect public health interventions.
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Centers for Disease Control and Prevention, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion. (n.d.). Estimating the Number of Pregnant Women in a Geographic Area: A Reproductive Health Tool. (Accessed 6/2/2022.)
This factsheet describes the process used to estimate the number of pregnant people in a United States jurisdiction at any given time. It can be used by emergency planners to ensure adequate resource allocation and tailored planning for vaccination and prophylaxis activities in particular.
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Harville, E.W., Xiong, X., and Buekens, P. (2010). Disasters and Perinatal Health: A Systematic Review. Obstetrics and Gynecological Survey. 65(11): 713728.
The authors examine the existing evidence on the effect of disasters on perinatal health. While there is evidence that disaster impacts maternal mental health outcomes and some perinatal health outcomes, the authors suggest that future research focus on under-studied outcomes such as spontaneous abortion.
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Maher, M. (2019). Emergency Preparedness in Obstetrics: Meeting Unexpected Key Challenges. The Journal of Perinatal and Neonatal Nursing. 33(3):238-245.
This article discusses challenges in perinatal emergency preparedness, including obstetric triage, surge capacity, sheltering in place, trauma in pregnancy, mental health, and management of special pathogens. Recommendations for addressing the challenges are included.
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MotherToBaby. (2024). MotherToBaby.
This website provides information on the risks/benefits of medications and other exposures (e.g., during environmental or natural disasters) during pregnancy and while breastfeeding.
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New York State Department of Health, Health Emergency Preparedness Program, and Division of Family Health Office of the Medical Director. (2017). Pediatric and Obstetric Emergency Preparedness Toolkit.
This revised version of a previously released toolkit is targeted to “hospitals that do not have pediatric intensive care services or obstetric or newborn services and must prepare for such patients during the time of a disaster.” The document discusses: planning guidelines; staffing considerations; training; security; infection control; hospital-based pediatric triage; decontamination; prophylaxis; transportation of pediatric patients; surge considerations; equipment considerations; disaster preparedness for childbirth; psychosocial needs of children; and family information and support centers.
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Pinkert, M., Dar, S., Goldberg, D., et al. (2013). Lessons Learned from an Obstetrics and Gynecology Field Hospital Response to Natural Disasters. Obstetrics and Gynecology. 122(3): 532-536.
Field hospital teams from the Israel Defense Forces were deployed to Haiti and Japan in response to natural disasters. The authors stress the importance of sending obstetrician-gynecologists on disaster response missions and share ten lessons learned from both deployments.
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* Polen, K. and Ellington, S. (2018). Protecting Pregnant Women and Babies During Public Health Emergencies. Centers for Disease Control and Prevention, Office of Public Health Preparedness.
This webinar can help healthcare providers can learn more about the impact of public health emergencies like Zika and H1N1 on pregnant people and babies.
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Stanford Medicine Obstetrics and Gynecology. (2015). Disaster Planning for Obstetrical Services.
This webpage contains components of a disaster planning toolkit for hospital Obstetrics and Gynecology departments, and addresses the issues of evacuation of labor and delivery and antepartum units as well as shelter-in-place for actively laboring patients. It includes generic forms hospitals may use for their plans.
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U.S. Department of Health and Human Services, Office of the Administration for Children & Families, Office of Human Services Emergency Preparedness & Response. (2013). Infant Feeding During Disasters.
This infographic summarizes key points including the importance of continued breastfeeding, common nursing challenges, and how first responders and other providers can assist and support women to continue breastfeeding.
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U.S. Department of Veteran's Affairs. (n.d.). DoD/VA Pregnancy Passport. (Accessed 3/12/2024.)
Pregnant people can download and complete this form to keep track of key pregnancy information. The form can also be useful in the event of an emergency should care be needed away from a pregnant people's regular hospital or clinic.
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UNC Center for Public Health Preparedness. (2018). Reproductive Health Assessment After Disasters A Toolkit for US Health Departments.
This toolkit can help healthcare providers assess the reproductive health needs of women aged 15-44 after a disaster. It includes links to a variety of resources including checklists, training resources, and instructions for analysis.
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Voxiva Inc. and ZERO TO THREE. (2017). Text4baby.
Text4baby is the nation's first free mobile phone messaging health service. It aims to reduce barriers to accessing information and resources, increase knowledge around key health topics, and improve positive health behaviors. In the event of an emergency, it could be used to communicate with expectant and new parents regarding health-specific topics (e.g., vaccination, treatment).
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Zotti, M.E., Williams, A.M., and Wako, E. (2015). Post-Disaster Health Indicators for Pregnant and Postpartum Women and Infants. (Free registration required.) Maternal Child Health Journal. 19(6):1179-88.
The authors identify post-disaster epidemiologic indicators for pregnant and postpartum women and their infants.
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Zotti, M.E., Williams, A.M., Robertson, M., et al. (2013). Post-Disaster Reproductive Health Outcomes. Maternal Child Health Journal. 17(5): 783796.
The authors examine disaster-related effects on reproductive health outcomes and fertility among women of reproductive age and infants in the U.S.
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Population-Specific Resources: Older Adults

Aldrich, N. and Benson, W.F. (2008). Disaster Preparedness and the Chronic Disease Needs of Vulnerable Older Adults. Preventing Chronic Disease. 5(1): A27.
The authors of this study discuss how planning and coordination among public health and emergency preparedness professionals and professionals who provide services for the aging are essential to meet the special needs of the elderly with chronic diseases. They note several tools and strategies already exist, and these include having professionals from diverse fields work and train in coalitions, ensuring that advocates for older adults participate in community-wide emergency preparedness, and using community mapping data to identify areas where many older adults live.
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* Alzheimer’s Association and RTI International. (n.d.). Disaster Preparedness: Home and Community-Based Services for People with Dementia and Their Caregivers. (Accessed 6/2/2022.) University of New England.
This guide provides public health officials, the Aging Services Networks, emergency management personnel, and partners at all jurisdictional levels the critical information, strategies, and resources they need to improve the planning for and protection of older adults during emergencies. The toolkit includes lessons learned from model programs or unique examples, and key preparedness actions for states and caregivers.
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American College of Surgeons, Trauma Quality Improvement Program. (2023). Best Practices Guidelines in Geriatric Trauma Management. Golden Crescent Regional Advisory Council (Texas).
This document provides detailed clinical guidelines for treating geriatric trauma patients. It discusses how advanced age and medications can impact how older adults experience trauma, and how to adapt standard trauma protocols and policies to address these factors.
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American Psychological Association. (n.d.). Older Adults and Disasters: How to be Prepared and Assist Others. (Accessed 4/20/2020.)
This tip sheet provides information for older adults regarding how to prepare for disasters.
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Brown, L.M., Dosa, D.M., Thomas, K., et al. (2012). The Effects of Evacuation on Nursing Home Residents with Dementia. (Abstract only.) American Journal of Alzheimer’s Disease and Other Dementias. 27(6): 406-12.
The authors of this report discuss their findings from research conducted on the effects of evacuation from Hurricane Gustav on residents with severe dementia which showed a demonstrable increase in mortality.
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Centers for Disease Control and Prevention. (2012). Identifying Vulnerable Older Adults and Legal Options for Increasing Their Protection During All-Hazards Emergencies: A Cross-Sector Guide for States and Communities.
This planning guide for community-dwelling older adults during public health emergencies provides recommendations for developing plans, partnering with key stakeholders, building registries and using data, and integrating shelter and caregiver preparedness. The guide is written for public health officials, aging services network, emergency management agencies, and other partners at all jurisdictional levels.
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Choose Energy. (2019). Electricity Emergency Preparedness for Senior Citizens and their Caretakers.
The guidance on this web page can help older adults and their caretakers plan for, respond to, and recover from power outages.
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Florida Department of Health. (2014). Continuum of Care Model: Caring for Elders during Disasters: A Guide for Community-Based Planning.
The purpose of this project was to provide information and resources to guide and support local communities in their efforts to develop and sustain a continuum of care for older adults during disasters. This document provides a comprehensive guide to communities for engaging older adult care stakeholders in the preparedness, response, and recovery cycles of all-hazards disaster management.
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Gotanda, H., Fogel, J., Levine, J.M., et al. (2015). Hurricane Sandy: Impact on Emergency Department and Hospital Utilization by Older Adults in Lower Manhattan, New York (USA). Prehospital and Disaster Medicine. 30(5): 496-502.
The authors examined emergency department (ED) visits by geriatric patients in Manhattan after Hurricane Sandy. Older patients were more likely to report to the ED than younger patients because of secondary effects of power outages (e.g., on dialysis and respiratory treatment).
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Heid, A., Christman, Z., Pruchno, R., et al. (2016). Vulnerable, but Why? Post-traumatic Stress Symptoms in Older Adults Exposed to Hurricane Sandy. (Free registration required.) Disaster Medicine and Public Health Preparedness. 10(3):362-70.
Post-traumatic stress disorder symptoms were much more likely in older adults affected by Hurricane Sandy who had lower levels of income, positive affect, employment, and other factors that may allow for targeted interventions to increase pre-event resilience and promote post-event recovery.
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HHS At-Risk Individuals. (2022). HHS/ASPR: Addressing the Needs of Older Adults in Disasters Training. U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response.
The HHS ASPR Addressing the Needs of Older Adults in Disasters Web-Based Training is designed to improve public health and emergency medical responders’ capability to address the access and functional needs of community-dwelling older adults in common disaster situations, including infectious disease outbreaks.
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Jenkins, J., Levy, M., Rutkow, L., and Spira, A. (2014). Variables Associated with Effects on Morbidity in Older Adults Following Disasters. PLOS Currents Disasters.
The authors examined nine studies for comprehensive review on variable that are associated with older adults and poor health outcomes during disasters. They found several factors related to an increased risk of morbidity (e.g., the need for prescription medications, low social support, visual and hearing impairment, impaired mobility, and poor economic status).
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Ling, S., McBee, E., and Johnson, H. (2014). Curriculum Recommendations for Disaster Health Professionals. The Geriatric Population. National Center for Disaster Medicine & Public Health, Uniformed Services University of the Health Sciences.
This reference tool can help educators, program directors, and curriculum developers ensure that courses they are developing specific to older patients meet the specific needs of this population.
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SeniorLiving.org. (2021). Disaster Preparedness Guide for Seniors and Caregivers.
This guide covers the common types of emergencies to be aware of, tips for helping older people evacuate, and a checklist of items to bring. It also includes links to helpful information for seniors and their caregivers.
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U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response, At-Risk Individuals, Behavioral Health & Community Resilience (ABC). (2020). Working with Older Adults and People with Disabilities: Tips for Treatment and Discharge Planning.
This resource includes information for healthcare providers to ensure that patients who are older or have disabilities meet the requirements for safe, post-disaster discharge planning. It is also available in Spanish: https://www.phe.gov/Preparedness/planning/abc/Pages/elderly-disabled-spanish.aspx.
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Population-Specific Resources: People Experiencing Homelessness

Division for At-Risk Individuals, Behavioral Health, and Community Resilience (ABC). (2012). Disaster Response for Homeless Individuals and Families: A Trauma-Informed Approach. U.S. Department of Health and Human Services, Administration for Strategic Preparedness and Response.
This factsheet includes tips for responders when disaster planning for people experiencing homelessness and families. Responders are encouraged to incorporate a trauma-informed approach (i.e., recognize that many members of the population have high rates of past trauma) when planning and responding. Links to additional resources are provided.
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Edgington, S. (2009). Disaster Planning for People Experiencing Homelessness. National Health Care for the Homeless Council.
This publication provides an overview of important issues to consider when planning for the needs of individuals experiencing homelessness during disasters. Practical guidance is offered to local officials, emergency planners, homeless service providers and others who are involved in their community’s emergency planning process. The final part of this publication encourages Health Care for the Homeless providers and others involved in homeless service provision to participate in disaster planning efforts in their communities.
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Morris, S. (2020). Disaster Planning for Homeless Populations: Analysis and Recommendations for Communities. Prehospital and Disaster Medicine. 35(3):322–325.
The author reviewed existing disaster plans and recommendations for populations experiencing homelessness and describes considerations for the factors that make them more vulnerable to disasters, such as shelter concerns, financial and material resource constraints, mental and physical health concerns, violence, and substance abuse. He advocates for the inclusion of homeless service providers in disaster planning, and an improved understanding of the complex issues facing individuals experiencing homelessness to address these challenges.
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National Health Care for the Homeless Council. (2014). Integrating Homeless Service Providers and Clients in Disaster Preparedness, Response, and Recovery.
This issue brief outlines strategies to integrate the needs of people experiencing homelessness into broader emergency preparedness efforts. It examines individuals experiencing homelessness' and service providers' awareness and perception of targeted preparedness efforts, and offers recommendations for other communities looking to improve disaster assistance for people experiencing homelessness.
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U.S. Department of Veterans Affairs, the U.S. Department of Health and Human Services, and the U.S. Department of Housing and Urban Development. (2017). Disaster Preparedness to Promote Community Resilience: Information and Tools for Homeless Service Providers and Disaster Professionals.
This toolkit includes information that can help emergency and public health officials, homeless service providers, and healthcare providers work together to plan for the disaster needs of people experiencing homelessness in their communities. It is separated into three sections: Creating an Inclusive Emergency Management System, Guidance for Homeless Service Providers: Planning for Service Continuity, and Guidance for Health Care Providers.
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Population-Specific Resources: People with Chronic Medical Conditions

Arrieta, M.I., Foreman, R.D., Crook, E.D., et al. (2008). Insuring Continuity of Care for Chronic Disease Patients after a Disaster: Key Preparedness Elements. The American Journal of the Medical Sciences. 336(2): 128–133.
The objective of this study was to address challenges and develop solutions in the provision of healthcare to those with chronic diseases. The authors focused specifically on aftermath of Hurricane Katrina in coastal Alabama and Mississippi.
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ASPR TRACIE. (2016). Emergency Prescription Assistance Program (EPAP): Hurricane Gustav Data Fact Sheet. U.S. Department of Health and Human Services, Assistant Secretary for Preparedness and Response.
This fact sheet provides a summary of the EPAP data collected and analyzed following Hurricane Gustav from September 2, 2008 to October 31, 2008.
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ASPR TRACIE. (2016). Emergency Prescription Assistance Program (EPAP): Overview Fact Sheet. U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response.
The Emergency Prescription Assistance Program (EPAP) is funded by the Stafford Act and designed to help disaster survivors access prescription medicines. EPAP can also be activated by the Public Health Service Act under the authority of the National Disaster Medical System (NDMS). The program utilizes normal business operations (e.g., electronic prescription claims processing, utilization of the normal pharmaceutical supply chain for distribution and dispensing) to pay for prescription medications for eligible persons.
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ASPR TRACIE. (2016). Emergency Prescription Assistance Program (EPAP): Superstorm Sandy Data Fact Sheet. United States Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response.
This fact sheet provides a summary of the EPAP data collected and analyzed following Superstorm Sandy for New Jersey and New York through October 30, 2013.
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ASPR TRACIE. (2017). Emergency Prescription Assistance Program (EPAP) Louisiana Floods Data Fact Sheet. U.S. Department of Health and Human Services, Assistant Secretary for Preparedness and Response.
This fact sheet provides a summary of the EPAP data collected and analyzed following the Louisiana flooding from August 19, 2016 to September 20, 2016.
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ASPR TRACIE. (2019). Benefits of Coordinated Emergency Planning and Response, and Hospital Emergency Department Utilization during Disasters.
This ASPR TRACIE TA response provides scholarly articles and other resources on: 1) the benefits of coordinated emergency planning and response efforts in a region, and 2) the impact that individuals with access and functional needs have on the utilization of hospital emergency department pre-, during- and post-disaster.
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Centers for Disease Control and Prevention. (2017). Emergency Preparedness and Disability Inclusion.
This webpage provides links and information to several resources for people with chronic conditions, such as diabetes, high blood pressure, and blood disorders.
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Miller, A.C. and Arquilla, B. (2008). Chronic Diseases and Natural Hazards: Impact of Disasters on Diabetic, Renal, and Cardiac Patients. Prehospital and Disaster Medicine. 23(2):185-94.
The following study assessed the burden of chronic renal failure, diabetes, and cardiovascular disease during disasters due to natural hazards, identified impediments to care, and proposes solutions to improve disaster preparation and management of those with chronic disease.
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Sasabuchi, Y., Matsui, H., Yasunaga, H., and Fushimi K. (2016). Increase in Avoidable Hospital Admissions after the Great East Japan Earthquake. (Abstract only.) Journal of Epidemiology and Community Health. 71(3):248-252.
Early intervention may reduce avoidable hospital admissions for new acute conditions in the months following an area impacted by a natural disaster.
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Sharma, A.J., Weiss, E.C., Young, S.L. et al. (2008). Chronic Disease and Related Conditions at Emergency Treatment Facilities in the New Orleans Area after Hurricane Katrina. (Abstract only.) Disaster Medicine and Public Health Preparedness. 2(1):27-32.
This abstract of research conducted after Hurricane Katrina describes the results of a study related to chronic disease and related conditions (CDRCs) patient populations.
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Suneja, A., Chandler, T.E., Schlegelmilch, J., et al. (2018). Chronic Disease After Natural Disasters: Public Health, Policy, and Provider Perspectives. Columbia University, Earth Institute, National Center for Disaster Preparedness.
This report provides public and private state and local stakeholders with information to help them better understand and support the post-disaster needs of individuals with chronic conditions. It highlights the strengths and weaknesses that have been experienced, or are anticipated in current approaches to this issue.
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Tomio, J. and Sato, H. (2014). Emergency and Disaster Preparedness for Chronically Ill Patients: A Review of Recommendations. Open Access Emergency Medicine. 6: 69–79.
The authors of this study reviewed reports from recent disasters in developed countries and summarized the recommendations, based on lessons learned, for disaster preparedness of chronically ill patients. These recommendations also provide practical and essential steps to prevent treatment interruption during and after a disaster.
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U.S. Department of Health and Human Services. (2018). Guidance for Non-HIV-Specialized Providers Caring for HIV-Infected Residents Displaced from Disaster Areas: Essential Information for Managing HIV-Infected Patients Receiving Antiretroviral Therapy.
The following information provides guidance to healthcare providers attending to the medical needs of HIV-infected adults (including pregnant people) or children displaced from disaster areas who have not yet secured HIV care in the areas where they have relocated.
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U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response. (2012). Planning Considerations for the Extremely Obese.
Results from the latest National Health and Nutrition Examination Survey (NHANES), indicate that an estimated 5.7% of U.S. adults aged 20 years and over are extremely obese. Considerations for individuals with obesity are critical when planning for emergency preparedness, response, and recovery, as they will require more resources and may present significant logistical challenges in patient transport and patient care. This resource guide addresses planning considerations for caring for the extremely obese during disasters.
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U.S. Food and Drug Administration. (n.d.). FDA Offers Tips about Medical Devices and Hurricane Disasters. (Accessed 6/2/2022.)
This website offers guidance on the general safety and operation of medical devices following hurricanes.
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U.S. Food and Drug Administration. (2017). Information Regarding Insulin Storage and Switching Between Products in an Emergency.
Insulin from various manufacturers is often made available to patients in an emergency and may be different from a patient's usual insulin. After a disaster, patients in the affected area may not have access to refrigeration. This website provides information for patients and providers regarding those issues.
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U.S. Food and Drug Administration. (2019). Safe Drug Use after a Natural Disaster.
The Center for Drug Evaluation and Research (CDER) at the U.S. Food and Drug Administration offers information on the use of drugs that have been potentially affected by fire, flooding or unsafe water, and the use of temperature-sensitive drug products when refrigeration is temporarily unavailable.
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University of Louisville Hospital. (2013). Disaster Preparedness for Persons with Chronic Disease. Kentucky Department for Public Health, Chronic Disease Prevention Branch.
This manual can help people with chronic disease prepare for disasters. It also includes specific information geared towards disease-related preparedness challenges.
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World Health Organization, UN Interagency Task Force on NCDs. (2016). Noncommunicable Diseases in Emergencies.
This brief is intended primarily for emergency planners, emergency professionals, and policy makers tasked with emergency preparedness and response. It provides an overview of the impact of emergencies on people with noncommunicable diseases (NCDs), and describes the minimum standard and emergency actions to be adopted in relation to NCD emergencies.
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Population-Specific Resources: Tribal Communities

Bryan, R., McLaughlin Schaefer, R., DeBruyn, L., and Stier, D. (2009). Public Health Legal Preparedness in Indian Country.
This article describes how tribal laws impact public health preparedness. At the time it was published, a study of 70 tribal codes found that 14 (20%) had no clearly identifiable public health provisions and the remaining codes were rarely well-integrated or comprehensive.
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Federal Emergency Management Agency. (2021). Tribal Affairs.
The goal of Tribal Affairs is to collaborate with tribal governments to build emergency management capability and partnerships to ensure continued survival of tribal nations and communities. The website provides brochures, public service announcements, and poster resources.
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Heritage Preservation. (2010). Getting Ready in Indian Country: Emergency Preparedness and Response for Native American Cultural Resources.
This document provides emergency preparedness considerations specifically for Native American interests. It has three parts: (1) a brief report exploring the issues and making recommendations to address those issues; (2) an “Inventory of Disaster Resources for Cultural Heritage;” and (3) Preparedness Discussion Questions designed to be shared within and among tribal nations. Taken as a whole, the report and accompanying tools are intended to advance emergency preparedness, stimulate discussion, and inspire new initiatives in American Indian/Alaska Native (AI/AN) communities.
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U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. (2009). CultureCard: A Guide to Build Cultural Awareness.
This guide provides basic information for federal disaster responders and other service providers who may be deployed or otherwise assigned to provide or coordinate services in American Indian/Alaska Native communities.
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U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. (2022). Tips for Disaster Responders: Cultural Awareness When Working in Indian Country Post Disaster.
This tip sheet for behavioral health responders outlines the types of traumatic events that can occur in Indian Country and examples of effective response techniques such as use of traditional teachings and talking circles.
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U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. (2022). Tips for Disaster Responders: Understanding Historical Trauma and Resilience When Responding to an Event in Indian Country. Substance Abuse and Mental Health Services Administration, Disaster Technical Assistance Center.
This tip sheet for responders provides a description of the effects of historical trauma on American Indian/Alaska Natives, and tips for how responders can respond effectively to a disaster or other traumatic event in Indian Country.
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Agencies and Organizations

Administration for Children and Families. Office of Human Services Emergency Preparedness and Response. U.S. Department of Health and Human Services.
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Association of University Centers on Disabilities. National Technical Assistance and Training Center on Disability Inclusion in Emergency Preparedness: Prepared4ALL.
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Centers for Disease Control and Prevention Emergency Preparedness and Response: Information for Specific Groups.
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Federal Emergency Management Agency. Resources are Available to FEMA’s Diverse Audience.
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Federal Emergency Management Agency. Office of Disability Integration and Coordination.
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Medline Plus. Health Information in Multiple Languages. National Institutes of Health, National Library of Medicine.
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National Language Service Corps.
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National Organization on Disability.
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The Partnership for Inclusive Disaster Strategies.
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U.S. Department of Health and Human Services Office for Civil Rights.
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U.S. Department of Health and Human Services Office of Behavioral Health, Disability, and Aging Policy (BHDAP).
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U.S. Department of Health and Human Services, Administration for Strategic Preparedness and Response. At-Risk Individuals.
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U.S. Department of Health and Human Services, Assistant Secretary for Preparedness and Response Addressing the Access and Functional Needs of At-Risk Individuals.
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U.S. Department of Health and Human Services, Health Resources and Services Administration Emergency Medical Services for Children Program.
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U.S. Department of Justice, Civil Rights Division. Emergency Preparedness and Response.
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U.S. Department of Labor Office of Disability.
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This ASPR TRACIE Topic Collection was refreshed and comprehensively reviewed in June 2022 by the following subject matter experts (listed alphabetically):

Kristen Finne, Director of the HHS emPOWER Program and Senior Program Analyst, Office of Emergency Management and Medical Operations; John Hick, MD, Hennepin Healthcare (MN); June Isaacson Kailes, Disaster Policy Consultant, California Disaster Coalition, Cheryl Levine, PhD, Division for At-Risk Individuals, Behavioral Health, and Community Resilience, HHS ASPR; Mary Russell, EdD, MSN, Healthcare Emergency Response Coalition, Palm Beach County Florida; Molly Rutledge, M.A., M.S., CDR, USPHS and IHS Chief Clinical Consultant for Rehabilitation Specialists, Pain Management/Rehabilitation Lead, IHS National Committee on Heroin, Opioids & Pain Efforts; and Susan Wolf-Fordham, JD, MPA, Deputy Director, National Tech Assistance & Training Center on Disability Inclusion in Emergency Prep at Association of University Centers on Disabilities.

It was comprehensively reviewed in June 2015 by: Elizabeth Davis, JD, EdM, EAD & Associates, LLC; Daniel Dodgen, PhD, Division for At-Risk Individuals, Behavioral Health, and Community Resilience, HHS ASPR; John Hick, MD, Hennepin Healthcare (MN); LT Tala Hooban, MPH, CHES, CPH, HHS Administration for Children and Families, Office of Human Services Emergency Preparedness and Response; June Isaacson Kailes, Disability Policy Consultant, Associate Director at Harris Family Center for Disability and Health Policy, Western University of Health Sciences; Cheryl Levine, PhD, Division for At-Risk Individuals, Behavioral Health, and Community Resilience, HHS ASPR; Jed Levine, Alzheimer’s Association, New York City Chapter; Mary Casey Lockyer, American Red Cross; LT Darielis Williams, HHS Administration for Children and Families, Office of Human Services Emergency Preparedness and Response.

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