In 2014, on any given night in January, over half a million people in the United States experienced homelessness. The health challenges that people experiencing homelessness face every day are daunting and can include extreme poverty, complex medical conditions, substance abuse, mental health disorders, and lack of access to proper housing or other basic resources. These health issues often become worse when disaster strikes. Understanding the risk factors that impact individuals experiencing homelessness is a critical step in developing disaster preparedness, response, and recovery strategies that meet the whole community’s needs.

Community disaster plans generally do not consider the access and functional needs of individuals experiencing homelessness. Planning for the needs of individuals experiencing homelessness helps the community respond and recover more effectively as a whole. As part of the planning process, communities need to engage health care providers, such as clinicians, in maintaining and supporting individuals experiencing homelessness. When a disaster occurs, a reliable network and service delivery system of health care providers familiar with the needs of individuals experiencing homelessness is essential to their long-term recovery.

To help health care providers get involved in planning and addressing the unique needs of individuals experiencing homelessness, ASPR is to announcing the publication of the Disaster Response Guidance for Health Care Providers: Identifying and Understanding the Health Care Needs of Individuals Experiencing Homelessness (DRG for Health Providers). The DRG for Health Providers includes practical tools to facilitate pre-disaster coordination and planning, disaster response, and recovery. It is organized into the following four themes:

1. Needs Identification and Assessment
2. Prevention of Hospital System Surge and Coordination of Care
3. Medical Capacity Available for Ready Mobilization in Disasters, and
4. Information and Education Resources

This guidance encourages health care providers to consider pre-existing medical conditions, family medical history, and cultural competency when assessing the needs of and providing care to individuals experiencing homelessness. Health care providers are also urged to assess and consider the strengths of these individuals, and develop relationships with service providers who offer care to individuals experiencing homelessness before a disaster occurs.

The DRG for Health Providers is part of a larger toolkit by the Veterans Emergency Management Evaluation Center (VEMEC), which includes contributions from ASPR, and several other HHS agencies including the Health Resources and Services Administration (HRSA), the Centers for Disease Control and Prevention (CDC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). The VEMEC-led toolkit is being developed to help practitioners and policymakers more effectively integrate individuals experiencing homelessness into disaster preparedness, planning, and response plans. The final toolkit will include two additional sections: 1) Training and Technical Assistance for Community-Based Organizations and Non-Governmental Organizations and 2) Communications and Coordination.

During a disaster, public health officials and emergency management personnel may be overwhelmed with addressing the needs of an entire community. By developing relationships and educating health care providers on the needs of individuals experiencing homelessness, the reach of emergency planners and first responders is extended while ensuring the inclusion of an often neglected group in response and recovery efforts.