Shelters for Special Needs Populations

Preface

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 “best practices” and
“lessons learned” testimony, articles and documents.

Overview

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 “best
practice” 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
model).

Some states, for example Virginia, are in the process of deciding whether or not they should have
a “special needs” 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
have.

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.

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Examples of State Plans for Special Needs Shelters
Hawaii
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
hospitals.

Florida
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’s 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 –
located in Marianna, Gainesville and Fort Myers – 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
service.

Brevard County, Florida

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, California

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.

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Connecticut
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 “universally accessible disaster relief shelters”, 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 “special” sheltering arrangements is reduced.

Louisiana
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
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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 Shelters for Special Needs Populations
Planning Considerations
This document identifies issues to be considered in the development of shelters for special needs
populations. The information has been compiled from a wide variety of public, private and
advocacy organization web sites and documents, but is neither exhaustive nor equally applicable
to all situations.

Authority, Purpose and Support

• The special needs shelter has been approved or mandated by local authorities.
• For sheltering purposes, the term “special needs” is defined.
• Costs have been established, and a funding source is identified.

Collaboration

• The entities collaborating in the effort are identified.

• The entity taking the lead in the effort is identified.
• Formalized agreements between and among the collaborating entities are in place or
under discussion.

Administrative Decisions

• Decisions are made on the types of services provided in the shelter.

• Decisions are made on the type and level of staffing provided in the shelter.
• The decision is made on whether or not caregivers and/or families will be sheltered at the
same location.
• Decisions are made on how many individuals with special needs (and their caretakers or
family members, if sheltered together) can be sheltered and for how long.
• The decision is made on whether or not transportation is provided to and from the shelter.
• The decision is made on whether or not a special needs registry is used in conjunction
with the special needs shelter.

Design and Operations

• The entity in charge of operating the shelter during emergencies is identified.

• Decisions are made on whether or not the shelter provides the following:
o Medical/nursing oversight
o Assistance in obtaining, storing and administering vital medications
o Critical supplies and equipment (e.g., oxygen, DME)
o Physical plant accessibility
o Emergency power generation
o Volunteers to work with the special needs population
• The special needs shelter has been tested or activated in an actual emergency.

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 Resource Listing for Special Needs Shelters

Alameda County, California, Disaster Shelter Plan for Medically Fragile Persons
http://www.acgov.org/ems/Resource/Med_Fragile_Shelter_Plan_11_2_04.pdf

Brevard County, Florida, Special Needs Program (shelters, registry, transportation)

http://embrevard.com/special_needs.cfm

Commonwealth of Virginia Emergency Operations Plan, Emergency Support Function #6

www.vaemergency.com/library/plans/coveop/eopvol2/sept2007/14COVEOP_ESF6.pdf

Connecticut State Office of Protection and Advocacy for Persons with Disabilities
www.ct.gov/opapd/ -- use the site search engine to search for Universal Access versus Special
Needs and/or Emergency Shelter Accessibility Checklist

Fairfax County, Virginia (medical shelters, medical needs registry)

http://www.fairfaxcounty.gov/specialneeds/medicalneedsregistry.htm

Florida Department of Health, Special Needs Shelter Program

http://www.doh.state.fl.us/PHNursing/SpNS/SpecialNeedsShelter.html

Florida Department of Health, Chapter 64-3, Special Needs Shelters (shelters, registry)
http://www.floridadisaster.org/SpecialNeeds/Documents/2007/DOH%2064-
3%20SpNS%20rule%20Nov%2007.pdf

Florida Division of Emergency Management, 2008 Statewide Emergency Shelter Plan

http://www.floridadisaster.org/response/engineers/2008SESP.htm

Florida State-Owned Special Needs Shelters (three facilities)

http://www.floridadisaster.org/eoc/eoc_Activations/Press06/Reports/Disabilities.pdf

Hawaii, 2008 Interagency Action Plan for the Emergency Preparedness of People with
Disabilities and Special Health Needs
www.state.hi.us/health/dcab/ (Disability and Communication Access Board, scroll down to
document)

Indian River County, Florida, Comprehensive Emergency Management Plan 2007 (shelters,
registry)
www.irces.com/Emergency_Management_Division/CEMP.pdf

Louisiana Department of Social Services, Emergency Support Function 6: Mass Care, Housing
and Human Services, State Sheltering Plan Summary, May 2007
www.dss.state.la.us/Documents/DSS/ShelterPlanSummarywl.pdf

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Louisiana Department of Social Services, Office of the Secretary, Frequently Asked Questions,
Shelter FAQs, May 2007
http://www.dss.state.la.us/Documents/DSS/shelterFAQs51807.pdf

Mobile County, Alabama, Medical Needs Shelters

www.mobilecountyhealth.org/PDF/medicalneeds.pdf

North Carolina, http://www.fullcirclecare.org/caregiverissues/disaster/personprepare.html

Palm Beach County, Florida, Special Needs Program (shelters, registry, transportation)
www.ci.highland-beach.fl.us/index.asp?nid=202

State of Florida, Office of the Governor, Executive Order Number 07-21

www.flgov.com/pdfs/orders/07-21-weather.pdf

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