Exercise integrates planning for people with functional needs in general population shelter

In Brief

Georgia's East Central Health District worked with numerous partners, including the American Red Cross, to test establishing a general population shelter that could accommodate patients with functional needs. Using a whole community approach, planners integrated space and equipment for people with physical and mental disabilities, caregivers, and people with medical needs at a congregate shelter.


When developing programs that can provide the most benefit to the most people during a disaster, public health agencies consider using a "whole community approach." In this guiding principle, everyone potentially involved in a response (residents, health professionals, emergency managers, community and nonprofit leaders, and government officials) assesses how aspects of their communities can be strengthened in order to withstand the effects of a catastrophe.

The whole community approach can be particularly applicable to planning for the diverse medical and social needs of people affected by a disaster. People with functional needs (eg, people with physical, sensory, mental health, cognitive, and intellectual disabilities, some older adults, women in the late stages of pregnancy, and people affected by morbid obesity) may not be able to stay healthy and safe or recover from a disaster without appropriate assistance.

Specific issues
  • Functional needs issues in emergency shelters. When forced to evacuate their homes during a disaster, many people with functional needs are unable to remain independent or safe in a general population shelter.
  • Diversion of people with functional needs to medical needs shelters. If services for people with functional needs are unavailable in general population shelters, they may be asked to stay at a medical needs shelter. This may separate them from their families and place additional strain on medical surge.
The practice

Georgia's East Central Health District (ECHD) assisted in coordinating an exercise to integrate support services for people with functional needs into general population shelters.

On April 25, 2012, ECHD took part in the National Disaster Medical System Exercise. During the "Planning for the Congregate Shelter" part of the day, health planners decided to use a whole community approach to integrate functional needs support services (FNSS) into a general population shelter. Planners worked under the assumption that people with functional needs could remain safe and independent in a general population shelter if provided with the proper support.

Exercise participants simulated a coastal evacuation of Georgia owing to an approaching Category 5 hurricane, while simultaneously modeling the arrival of 25 functional needs patients and 5 caregivers selected from Georgia's Chatham County FNSS registry. Functional needs represented included individuals who needed assistance with physical disabilities, mental health disorders, dementia, and wheelchair access. Planners integrated FNSS into the general population shelter by setting up a space to receive 90 patients at 40 square feet per individual, supplying 80 medical cots, and providing 10 enhanced medical cots to support patients weighing up to 500 pounds.

What made this practice possible?
  • Extensive inter-departmental collaboration. ECHD worked with governmental, social services, and advocacy groups to plan for FNSS in general population shelters. Exercise partners included the Augusta Chapter of the American Red Cross, the Richmond County Division of Family and Children Services, the ECHD Medical Reserve Corps, ECHD Emergency Preparedness, the Richmond County Health Department, Richmond County Environmental Health, the East Central Regional Hospital Department of Behavioral Health and Developmental Disabilities, the Richmond County Emergency Management Agency, the East Central Region Amateur Radio Emergency Services, Walton Options for Independent Living, and the South Carolina Health Occupation Student Association.
  • Multiple training opportunities. One week before the exercise, the Augusta Chapter of the American Red Cross held a 4-hour FNSS training at its district offices. On the day of the exercise, the Red Cross held a 1-hour just-in-time FNSS training.
  • Testing of shelter support services. Following the integration of FNSS considerations into the general population shelter exercise, ECHD and its partners had established training, infrastructure, and procedures that will support the needs of many functional-needs patients during a disaster evacuation.

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