At-Risk Individuals

At-risk individuals are people with access and functional needs that may interfere with their ability to access or receive medical care before, during, or after a disaster or emergency. Irrespective of specific diagnosis, status, or label, the terms “access and functional needs” are defined as follows:

• Access-based needs:  All people must have access to certain resources, such as social services, accommodations, information, transportation, medications to maintain health, and so on.
• Function-based needs:  Function-based needs refer to restrictions or limitations an individual may have that requires assistance before, during, and/or after a disaster or public health emergency.

The 2013 Pandemic and All-Hazards Preparedness Reauthorization Act defines at-risk individuals as children, older adults, pregnant women, and individuals who may need additional response assistance. Examples of these populations may include but are not limited to individuals with disabilities, individuals who live in institutional settings, individuals from diverse cultures, individuals who have limited English proficiency or are non-English speaking, individuals who are transportation disadvantaged, individuals experiencing homelessness, individuals who have chronic medical disorders, and individuals who have pharmacological dependency.

Fact Sheets

• Addendum: Delivering Personal Assistance Services in Congregate and Non-Congregate Sheltering
• At-Risk Individuals
• Cultural and Linguistic Competency in Disaster Preparedness and Response Fact Sheet
• Delivering Gender-Informed Health Services in Emergencies
  
• Direct Services Workforce Shortages during COVID-19
  
• Federal Disaster Case Management Program
• FEMA’s Functional Needs Support Services Guidance
• First Responders: Support for Pregnant Survivors of Abuse or Rape during Disasters
• HHS ASPR Addressing the Needs of Older Adults in Disasters Web-Based Training
•  Personal de Emergencia: Apoyo a Mujeres Embarazadas Sobrevivientes de Abuso o Violación durante Desastres
• Personal Preparedness for Individuals with Disabilities: Sheltering in Place and Evacuation
• Planning Considerations for the Extremely Obese for Disasters and Public Health Emergencies
• Promoting Stress Management for Pregnant Women during the Zika Virus Disease Outbreak: A Resource for Healthcare Providers
• Resources for Serving Persons with Limited English Proficiency 
• Understanding How to Accommodate Service Animals in Healthcare Facilities
• U.S. Public Health Service Assistance Teams
• Working with Older Adults and People with Disabilities: Tips for Treatment and Discharge Planning (PDF)
  

Video

• Emergency Management and Preparedness - Inclusion of Persons with Disabilities Webinar Series
• HHS/ASPR Access and Functional Needs Web-Based Training
• Public Health Emergency Discussion Series: Functional Needs for At-Risk Individuals
• Webinar:  Promising Practices and Technologies for Communicating with Persons with Access and Functional Needs
  

Tools

• HHS Maternal-Child Emergency Planning Toolkit
• ​2017 Hurricane Response - Resources for Children with Special Health Care Needs
• American Indian & Alaskan Native Disaster Preparedness Resource
• Capacity-Building Toolkit for including Aging & Disability Networks in Emergency Planning
• Census Bureau - Detailed Languages Spoken at Home and Ability to Speak English
• Cultural and Linguistic Competency for Disaster Preparedness Planning and Crisis Response
• Cultural Competency Curriculum for Disaster Preparedness and Crisis Response: Online Training from the Office of Minority Health
• Disaster Response Guidance for Health Care Providers: Identifying and Understanding the Health Care Needs of Individuals Experiencing Homelessness
• Disaster Preparedness Planning for Older Adults
• Disaster Preparedness to Promote Community Resilience: Information and Tools for Homeless Service Providers and Professionals​​​
• Ensuring Language Access and Effective Communication during Response and Recovery: A Checklist for Emergency Responders​ - (English) 
• ASEGURAR EL ACCESO AL IDIOMA Y A LA COMUNICACIÓN EFICAZ DURANTE LA RESPUESTA Y LA RECUPERACIÓN: LISTA DE VERIFICACIÓN PARA SOCORRISTAS - (Spanish) 
• Guidance to State and Local Governments and Other Federally Assisted Recipients Engaged in Emergency Preparedness, Response, Mitigation, and Recovery Activities on Compliance with Title VI of the Civil Rights Act of 1964
• Guidance on Integrating People with Access and Functional Needs into Disaster Preparedness Planning for States and Local Governments
• Pediatric Preparedness for Healthcare Coalitions
• Pediatric Preparedness for Healthcare Coalitions Part II Webinar
• Public Health Workbook to Define, Locate and Reach Special, Vulnerable, and At-Risk Populations in an Emergency (CDC)
• The Role of Healthcare Providers in Combatting Human Trafficking during Disasters
• Report Highlights Lessons Learned and Promising Practices for Meeting Needs of At-Risk Populations During Disaster Response

Reports

• 2014-2015 Report of the Children’s HHS Interagency Leadership on Disasters (CHILD) Working Group
• 2012-2013 Report of the Children’s HHS Interagency Leadership on Disasters (CHILD) Working Group
• 2011 Update on Children and Disasters: Summary of Recommendations and Implementation Efforts
• Listening Session on At-Risk Individuals in Pandemic Influenza and Other Scenarios: After Action Report
• Report of the Interagency Workgroup on Pandemic Influenza and At-Risk Individuals
• Report to Congress on HHS Efforts to Address Provisions in PAHPA Legislation Regarding At-Risk Individuals in Emergency Preparedness and Response
• Hurricane Sandy Recovery Workshop Summary Report: Lessons Learned and Promising Practices for Home and Community-Based Service Providers

Partner Resources

• At-Risk Populations and Pandemic Influenza: Planning Guidance for State, Territorial, Tribal, and Local Health Departments (ASTHO)
• Cultural Competency:  Resources from HHS Office of Minority Health
• Directory of Organizations Serving Older Adults
• Emergency Preparedness, Disability.gov
• Emergency Preparedness for Older Adults, CDC
• Health Resources on Children in Disasters and Emergencies (NLM)
• Health Resources on Pregnant Women in Disasters and Emergencies (NLM)
• HHS Administration on Aging, Emergency Preparedness and Response Information
• Individuals with Access and Functional Needs, FEMA
• Tips for Effectively Communicating with Protected Populations during Response and Recovery