State Policies Concerning Disaster Preparedness for Home- and Community-Based Service Providers

Abstract

Older adults are among those most vulnerable to harm in disasters, such as hurricanes and wildfires. Nursing homes and other Medicare providers are subject to federal requirements to develop detailed disaster plans. However, millions of older adults receive care at home from non-Medicare providers who are under federal disaster preparedness rules that are less prescriptive than Medicare rules and subject to state interpretation. This study assessed the disaster preparedness policies for Older Americans Act-funded home- and community-based programs in 10 states with high numbers of older adults and experience with disasters. We found considerable variation by state. The results raise questions about the protection provided to vulnerable individuals who receive care at home in some states. However, the policies of some other states indicate an awareness that government has a significant role in protecting older adults exposed to disasters and that disaster preparedness is a component of aging in place.

Disaster Preparedness in Home Care

“…There are many resources that could be integrated into the training of home care staff (see Table ). Home care agencies should seek to collaborate with formal support agencies at the local level to build relationships/coalitions and take part in community-wide training (Bell et al, 2021(Bell et al, , 2022Peterson et al, 2022). Attending communitylevel planning meetings could facilitate a better working knowledge of disaster planning in the community served (Anderson & Beach, 2022).…”

“…Another problem is the unwillingness of payers to respond to increased agency costs during a pandemic. Increased flexibility in reimbursement (Bell et al, 2022) and improved state-level policy (Peterson et al, 2022) should be examined.…”

“…Additionally, they suggest more research on role profiles within the four phases of disaster response. Understanding the relationship between preparedness and disaster outcomes could help better inform policy (Clarke et al, 2022; Peterson et al, 2022). Lastly, the impact of policy changes or underfunded investment in preparedness activities may also shed light on establishing best practices (Clarke et al, 2022).…”

“…The first is to ensure home care providers and staff are familiar with the emergency/disaster plan and are aware of the agency's scope of responsibility during an emergency/disaster (Bell et al, 2021; Citarella, 2017). Leaders must ensure adequate time and resources are dedicated to continuing education activities that prepare home care providers for their roles during a disaster (Anderson & Beach, 2022; Peterson et al, 2022).…”

“…Utilizing disaster planning checklists can assist providers to cover essential points with patients/caregivers (Wyte-Lake et al, 2019). Peterson et al (2022) suggest home care providers go beyond providing handouts and directly assist patients by using customizable plans and templates found online.…”