Preparedness Planning for Home Health Care Providers

During a disaster, you care for patients who do not require hospitalization or cannot be admitted into overwhelmed health care facilities. Depleted supplies, personnel shortages, and other challenges during times of crisis may strain your ability to address your patients’ needs. Good preparedness planning is essential for ensuring that the needs of patients, their service animals - and you, their caregiver - are met in the most effective and professional manner possible.

When planning for contingencies, you must consider a variety of hazards and events that could impact your patients. Hurricanes, floods, tornadoes, earthquakes, tsunamis, wildfires, radiation releases, chemical exposures, seasonal and pandemic influenza, and acts of terrorism are just a few examples.

There are simple measures that you can implement to increase the personal readiness of your patients and yourselves. Additionally, becoming familiar with existing emergency response plans, processes, and procedures in both your workplace and community is a critical component of preparedness.

Once you are armed with the necessary resources, help your patients, their family members, and other caregivers to be informed, get a kit and make a plan. You play a vital role in disaster preparedness because your patients depend on you for continuity of care during a catastrophic event.

Prepare Supplies

• Gather enough food, water, medication, and other life sustaining necessities for a minimum of three days and up to two weeks.
• If a back-up generator is available, ensure your patients or family members are familiar with how to safely operate it and have sufficient fuel.
• Provide patients or their family members with the required knowledge, tools, and supplies to maintain, replace, or repair essential medical devices, such as wheelchairs, ventilators, and oxygen tanks.
• Confirm your patients have a disaster supply kit. Get more information on creating disaster supply kits from www.ready.gov.

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Make a Plan

• If your organization is unable to ensure continuity of care, make sure your patients have a backup roster of home health care providers or an identified alternate means of care to ensure support during and after an emergency or disaster.
• Develop a plan for your patients and their family so you will know how you will communicate in a crisis.
• Discuss electrical needs for essential equipment (e.g., refrigeration for food and medication, air conditioning, heating, oxygen concentrators, and suction machines) with your patients, their family members, local emergency services providers, and local utilities companies.

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Going to an Evacuation Shelter

While staying in a well-prepared home with your help is often the best approach for your patient to get through a crisis, evacuation may be required.

You should consider evacuation as early as possible, even if it may prove later to be unnecessary, because of the challenges faced by those with special health needs. Remember, not all shelters can support everyone and service animals and pets also need our help.

To prepare for a possible evacuation:

• Contact the American Red Cross for information on shelters.
• Find out if there are alternate shelter plans in place in the event that your patients are not able to reach designated shelters.

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Sheltering

The criteria for staying in a special needs shelter varies by state or local government guidelines. In general, special needs shelters provide supervised care and shelter to a limited number of people requiring assistance due to pre-existing health conditions. Patients may qualify to stay at a special needs shelter if they are:

• Dependent on electricity to operate medical equipment
• In need of assistance with medication, injections, or simple dressing changes
• Receiving dialysis
• Receiving hospice services
• Demonstrating mild dementia, without abusive or wandering behavior.

You may be required to stay with your patients in special needs shelters during their stay. When assisting patients and their family members for special needs shelter planning, consider the following:

• Learn the health and safety resources the shelter provides.
• Determine which additional resources your patients will require if the shelter is not able to meet their needs.
• Review your organization’s plans, processes, and procedures for providing care and support for yourself and your patients while in the shelter.
• If patients are oxygen dependent, make arrangements to obtain extra supplies of oxygen canisters, refills, and other equipment as needed.
• Determine how patients will be transported to a special needs shelter and assist in making proper arrangements.
• Assist patients and their family members to prepare emergency supply kits with essential medications, equipment, and supplies that will not be provided by the shelter. Refer to www.ready.gov for a complete listing of kit supplies.
• Inform shelter managers if your patients have service animals. Companion animals (pets) are usually not permitted in special needs shelters.

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Household Pet and Service Animal Considerations

Service animals (e.g., seeing-eye-dogs, hearing and signal dogs, assistance dogs) must be allowed in shelters as extensions of the patient under the provisions of the Americans with Disabilities Act. Therapy animals, such as dogs who visit patients in hospitals and nursing homes, are not considered service animals. Many state and local jurisdictions will shelter pets. Coordinate with the local animal control to understand the options and inform patients and their family members so they can plan for their shelter needs.

Other pet and service animal considerations:

• Assist patients in making arrangements with family members, relatives, friends, or other providers to care for pets during an evacuation or other extended emergency.
• Plan for a minimum of three days and up to two weeks of food and water (and possible medications) for your patients’ pets and service animals.
• Prior to relocating to a shelter, help patients gather necessary food, medications, food and water bowls, cat litter, cages, collars (with tags and/or paperwork showing proof of immunizations, if possible), leashes, and muzzles.
• Contact animal control, the regional Humane Society or affiliate office, or a local veterinarian for more information. Additional information can be obtained from the
  Humane Society of the United States at www.hsus.org.

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