In the immediate aftermath of Hurricane Katrina in 2005, the City of New Orleans closed its methadone treatment programs. According to the Legal Challenges for Substance Abuse Treatment During Disasters study, this left some of the city’s most vulnerable residents unable to access treatment.
Many of these individuals and others were also displaced from their homes. They turned to homeless shelters that, in many cases, did not have the training or resources to care for them. When the individuals began developing signs of withdrawal, including diarrhea, some shelter staff mistook the symptoms as signs of an infectious disease outbreak and quarantined the individuals who were ill.
Sadly, people and families experiencing homelessness and those receiving substance use treatment are often the hardest hit when disasters strike, according to June Gin, Ph.D., a researcher at the Veterans Emergency Management Evaluation Center (VEMEC) in Los Angeles. According to research on Disaster Preparedness in Los Angeles County at the American Society of Civil Engineers (ASCE) by Gin and other colleagues, many organizations that serve homeless populations struggle to fit disaster preparedness planning into their already stretched schedules and budgets.
But without such plans in place, “the populations that depend on [these organizations] really suffer if organizations are not available to provide services during a disaster,” Gin said.
Gin explained that even when nonprofit organizations try to plan for disasters, they may struggle with the lack of systematic guidelines, standards, and metrics, or limited communication about what resources are available.
“What you have is communities making it up as they go along,” Gin said.
To fill this void, VEMEC has partnered with the Department of Housing and Urban Development’s (HUD) Special Needs Assistance Programs (SNAPS), the Department of Health and Human Services Assistant Secretary for Preparedness and Response (ASPR), and other stakeholders to create a new Homeless Disaster Planning Toolkit.
Gin noted that while veterans are a key population affected by homelessness, the toolkit aims to help organizations serving all people who are experiencing or at risk of experiencing homelessness.
The toolkit is divided into three sections, each with a different focus.
- Section One: Focuses on those providing clinical services during a disaster
- Section Two: Focuses on communications and coordination
- Section Third: Addresses training and technical assistance to help service practitioners prepare for disasters
For example, Gin said, many of the clinicians who will provide care during a disaster do not have experience working with people and families experiencing homelessness. As a result, they may be unfamiliar with the unique healthcare needs of people experiencing homelessness and may provide treatment advice that does not address pre-existing or new needs developed as a result of the disaster.
In some cases, it may be appropriate to coordinate with urgent care facilities to meet the non-acute needs of people experiencing homelessness. Planning and coordination of care efforts before a disaster strikes is critical to prevent hospital system surge, which can overwhelm the health care delivery system.
“It’s not good for anyone,” Gin said. “It’s in everyone’s interest to solve the problem.”
Another challenge addressed in the toolkit is how to plan for effective communication between emergency management, service providers, and people experiencing homelessness during a disaster. Gin noted that doing so requires organizations and emergency management to build relationships prior to a disaster to ensure that culturally competent, accessible, and effective communication is available to meet the diverse needs of the entire community confronting the devastating impacts of a disaster.
The final section of the toolkit deals with providing training and technical assistance to homeless service providers to improve their disaster preparedness, response, and ability to help those experiencing homelessness recover from disaster impacts. It includes templates, guidance, and instructions for nonprofit community-based organizations and entities to help them build their disaster capacity.
The toolkit brings together the best available resources Gin and her colleagues were able to gather from initiatives across the country and includes disaster preparedness templates and best practices used in communities nationwide.
“We decided not to reinvent the wheel and used other resources and best practices,” Gin said. “These are the lessons learned and our advice.”
Gin invited other organizations and cities to share their resources to continue to improve the toolkit. “We want it to be a living document, so we continue to build on it,” she said.
Learn about SAMHSA's disaster preparedness, response and recovery programs and about the Disaster Helpline, 1-800-985-5990, to support people experiencing emotional distress related to disasters. Access resources on emergency preparedness and disaster planning for people experiencing homelessness from National Health Care for the Homeless Council.
Access more behavioral health and homelessness resources.