The challenges faced during emergencies and disasters by individuals with special needs must be
addressed in every phase of emergency preparedness. The information in this document is
provided to support the efforts of local jurisdiction planners in addressing these issues. The
information has been compiled from a wide variety of public, private and advocacy organization
web sites and documents. Information has also been gathered from both \u201cbest practices\u201d and
\u201clessons learned\u201d testimony, articles and documents.
While shelters exclusively designed and designated for individuals with disabilities or special
needs are often stated as a goal or an ideal, there is generalized concern that establishment of
such shelters may not occur timely or may not be sufficiently or appropriately staffed and
equipped due to the strain on resources during a disaster. Some authorities have stated \u201cbest
practice\u201d as the designation of separate mass shelter areas for vulnerable individuals [see, for
example, Recommendations for Best Practices, published by, among other groups, the American
Medical Association and AARP]. Multiple separate areas might be needed in a mass care shelter
as it would be ill advised to mix certain vulnerable populations (e.g., some individuals with
mental disorders and the frail elderly) or to expect staff skilled in caring for one special needs
population to be fully skilled in caring for another. At the same time, however, there is some
cross-over expertise among skilled staff that could be available to more than one special needs
group if the groups are co-located in a mass care shelter.
Most states are discussing special needs shelters as an option, but relatively few have fully
committed to a specific course of action. All states have begun initiatives such as statewide
coordinating or planning committees tasked with looking comprehensively at the needs of the
elderly and people with disabilities relative to emergencies. Many are struggling with issues of
definition (e.g., who should be housed in what kind of shelter, medical model vs. functional
Some states, for example Virginia, are in the process of deciding whether or not they should have
a \u201cspecial needs\u201d shelter designation. Virginia currently blends all individuals in shelters, and is
creating guidelines for what constitutes a shelter and what services/features a shelter should
As noted, whether individuals with special needs should be sheltered separately or co-located in
shelters for the general population is often linked with the issue of resources and shelter
management expertise. States are concerned about the ability to adequately staff shelters.
Individuals with disabilities who are independent and capable of self-care or care by those who
are their daily caregivers will go to Level I (mass care) shelters. Individuals who have ongoing
enhanced special health needs who, by the nature of their condition, need a heightened level of
attention will go to Level II shelters. Examples include individuals using life support equipment
and those who require equipment normally found in a hospital or skilled nursing facility. Level
II shelters are not freestanding shelters; they are spaces with a Level I (mass care) shelter.
Individuals requiring acute medical care, defined as a Level III level of care, will be served in
Typical special needs shelters are available in every county for individuals who depend on
electric-powered medical equipment and require basic medical assistance and monitoring.
However, these special needs shelters are not usually equipped with advanced medical
equipment or medications, nor are they staffed to provide advanced medical care. In Executive
Order Number 07-21 (February 2007), the Governor directed the Department of Health to take
over the operation of all shelters intended for use by displaced persons with special personal,
medical or psychological needs, and to station licensed medical professional and
paraprofessional personnel at those shelters upon the request of any county\u2019s Director of
Emergency Management. In June of 2007, the Governor approved three new state-owned
special needs shelters operated by the Agency for Persons with Disabilities. The three facilities \u2013
located in Marianna, Gainesville and Fort Myers \u2013 will be better equipped than typical special
needs shelters to accommodate the unique needs of up to 7,000 persons with disabilities. All
three facilities are self-sufficient with electric generators, independent water sources and food
The Brevard County Special Needs Program is a space-limited program for individuals with
specific health and medical conditions. The Program provides registration, sheltering and
transportation with the resources available within the County. Individuals who elect to use a
Special Needs or other public shelter are advised to bring with them items such as cots, bedding,
medicine, and medical and food supplies, preparing to be self-sufficient for 72 hours.
Individuals who have registered in the Special Needs Program are also advised to be
accompanied by at least one caregiver. The Special Needs Program web site notes that most
shelters are located in public schools, and offer neither privacy nor luxuries.
Alameda County has a plan for activating a series of emergency shelter sites specifically for
medically fragile persons. These shelters will be managed through a collaborative effort between
the County Health Care Services Agency and the County Social Services Agency, with support
from the American Red Cross (ARC) and local jurisdictions.
The Connecticut Department of Emergency Management and Homeland Security, in conjunction with a number of state and local partners, developed draft guidelines for municipalities and tribal nations to use in developing and reviewing plans for their local disaster relief shelters. These draft guidelines promote the concept of \u201cuniversally accessible disaster relief shelters\u201d, which are congregate public shelters that are planned, equipped and operated to meet the sheltering needs of a wide variety of community members, including most people with disabilities and older adults. The goal is to ensure that disaster relief shelters are accessible and usable by all community members who normally live independently so that, wherever possible, families and neighbors can shelter together, and the need for \u201cspecial\u201d sheltering arrangements is reduced.
Louisiana has plans for a number of different types of shelters (general population, medical
special needs, critical transportation needs, and a shelter facility to house registered sex
offenders). The Louisiana Department of Social Services, in partnership with the Department of
Health and Hospitals, will run medical special needs shelters. These shelters will be for
individuals who require medical assistance with daily activities, but do not have conditions
severe enough to be admitted to or sheltered in hospitals.
North Carolina Special Needs Shelters are designed to offer a more comprehensive sheltering
service to individuals with special needs. The shelters have a registered nurse on staff and have
limited medications available. The shelters coordinate with local aging and health agencies to be
able to provide some services through these agencies. If available, a Special Needs Shelter is
recommended as the best choice for an individual who cannot function independently. These
shelters are opened on a county by county basis. Each county decides whether or not it can
afford to operate a Special Needs Shelter and whether or not there is a need for that type of
service during a particular emergency situation. Each county also determines what a Special
Needs Shelter will be able to offer and who qualifies to be sheltered there.
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