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Addressing the Access and Functional Needs of At-Risk Individuals

At-risk individuals are people with access and functional needs (temporary or permanent) that may interfere with their ability to access or receive medical care before, during, or after a disaster or public health emergency. 

Examples of at-risk populations may include but are not limited to children, pregnant women, older adults, people with disabilities, people from diverse cultures, people with limited English proficiency, people with limited access to transportation, people with limited access to financial resources, people experiencing homelessness, people who have chronic health conditions, and people who have pharmacological dependency.

At-Risk Populations

Visualization of examples of at risk individuals listed above

During a disaster or emergency, public health and medical professionals need to take action to protect the health of at-risk individuals. In addition, public health professionals and medical providers are often required by law or executive order to address the needs of at-risk individuals during disasters and emergencies.

  • At-Risk Individuals Fact Sheet: This fact sheet explains existing requirements under the Public Health Service Act  to address the needs of at-risk individuals, defines access and functional needs, and summarizes the CMIST Framework (Communication, Maintaining health, Independence, Support and Safety, and Transportation) for addressing common and crosscutting access and functional needs. (At-Risk Individuals Program)
  • Access and Functional Needs Web-Based Training: Addressing access and functional needs (AFN) is a crucial part of comprehensive disaster planning for the whole community and is mandated for inclusion in federal, state, local, tribal, and territorial public health emergency plans. ASPR has developed the HHS/ ASPR Access and Functional Needs Web-Based Training to help public health officials, emergency managers, and social/human service providers learn how to address AFN in disaster preparedness, response, and recovery. 
  • Access and Functional Needs: ASPR TRACIE Topic Collection: ASPR Technical Resources, Assistance Center, and Information Exchange (TRACIE) collected case studies, lessons learned, tools, and promising practices for working with individuals with disabilities during a disaster. This aims to prevent populations with access and functional needs from suffering disproportionately.
  • Guidance on Integrating People with Access and Functional Needs into Disaster Preparedness Planning for States and Local Governments: This guidance provides information to help state and local government planners to address the access and functional needs of at-risk individuals in the communities they serve during disasters and emergencies.  It includes resources on legislation, regulations, and executive actions. This guide also includes examples of real-world promising practices.
  • Public Health Workbook to Define, Locate, and Reach Special, Vulnerable, and At-Risk Populations in an Emergency: This book by the CDC explains what at-risk populations are and how to estimate the number of people with access and functional needs in your community. This resource includes information on locating at-risk populations using digital mapping or other alternatives; conducting surveys and focus groups; and analyzing the data.
  • Tools for Assessing the Scope of Access and Functional Needs within a Community: ASPR TRACIE compiled resources to help jurisdictions determine which community members have access and functional needs. This resource includes links that provide additional information about safety in a community with at-risk individuals.
  • Access and Functional Needs Toolkit: Integrating a Community Partner Network to Inform Risk Communication Strategies: This toolkit provides examples of groups who are at risk of being disproportionately impacted during and after an emergency. In addition, there is a four-step action plan that works to successfully integrate a network of community partners into the risk communication process. This allows communities to evaluate their communication and improve partner integration practices.
  • Advancing Equity Data Tools The Census Bureau's publicly available data sets and tools can assist federal agencies and other entities in the equitable distribution of resources, and in identify underserved communities. The Census Bureau collects comprehensive data from a multitude of sources about the nation’s economy and population, covering a range of topics, including demography, housing, socioeconomics, and businesses.
  • Legal Requirements for Addressing the Disaster Public Health and Medical Needs of At-Risk Individuals: This section provides details on the legal requirements of public health and medical professionals when working to address the needs of at-risk individuals. There are federal laws and executive order requirements that must be followed when planning for a disaster.
  • Disasters and Healthcare Disparity: An analysis and collection of resources on healthcare disparities after and during disasters. Underserved communities get hit especially hard during emergencies, so this list of technical resources focuses on health equity geared toward health care practitioners who are committed to addressing this disparity.
  • COVID-19 At-Risk Individuals Resources: This ASPR TRACIE collection of resources on COVID-19 preparedness, response, recovery, and mitigation efforts focuses on at-risk individuals who are vulnerable to COVID-19. There are plans, tools and templates of immediately implementable resources.
  • Engaging Community-Based Organizations: Promising Practices for Reaching At-Risk Individuals for COVID-19 Vaccination and Information: COVID-19 disproportionately impacted at-risk and underserved populations including communities of color and low-wage essential workers. This resource explains the importance of equity considerations for access to timely and accurate information and vaccination; describes the role of community-based organizations as trusted entities that know their clients and communities; and recommends ways to employ the CMIST Framework to address access and functional needs. (At-Risk Individuals Program)
  • Community-Based Organizations during COVID-19: This toolkit provides resources to help leaders of community-based organizations ensure continuity of operations and maintain programs during disasters. (At-Risk Individuals Program)
  • Telehealth Webinar for Community Based Organizations Series: This three-part webinar series explains the importance of telehealth services for at-risk individuals. Part one focuses on helping community-based organizations better understand issues related to services, payment, and partnerships surrounding telehealth services. Part two focuses on enhancing accessibility and language access. Part three focuses on addressing barriers to access and connectivity for people experiencing homelessness and low-income populations. Recordings, transcripts, and Q&A are provided. (At-Risk Individuals Program)
  • Hurricane Sandy Recovery Workshop Summary Report: Lessons Learned and Promising Practices for Home and Community-Based Service Providers: Nearly half of all people who died as a direct or indirect result of Hurricane Sandy were at-risk individuals. The National Association of County & City Health Officials (NACCHO), in partnership with ASPR, convened a workshop and released a report following Hurricane Sandy that details gaps in response operations of the tri-state area of New York, New Jersey, and Connecticut. The report describes challenges and lessons learned from home and community-based service providers and local health departments as well as innovations and promising practices to foster resilience and recovery to address the needs of at-risk individuals with access and functional needs. (At-Risk Individuals Program)
  • Information on Federal Programs to Sustain Nutrition for At-Risk Individuals: This resource provides a table with information on federal nutrition programs and the various at-risk populations they serve. This resource can be used to match federal nutrition programs by the category of recipient they serve and provides links to for additional information. (At-Risk Individuals Program)