How to Prepare your Patients
By discussing disaster preparedness during Texas Health Steps preventive medical checkups and other medical visits, providers can normalize disaster preparation and help families stay safe. It also may be helpful to check in with patients and families any time a disaster is likely (such as during hurricane season) by sharing safety tips via text, email or social media.
Disasters can impact health care. For example, they can cause families to delay vaccinations, lab work and medical screenings. Providers are encouraged to complete necessary screenings, lab work and vaccinations as soon as they are due. Aside from the overall health benefit of giving children timely preventive care, this strategy will boost children’s disease protection in case of disaster.
Select each section below to learn general recommendations for helping families plan, recommendations tailored for families with members who have special health-care needs or medical conditions, and resources to share with families.
- Helping Families Plan
A disaster plan is a key tool for families, in the same way that a fire safety plan or fire drill helps everyone know what to do and where to meet in case of fire. The core components of a family disaster plan include:
- Keeping medical records safe, ideally by having digital copies and having passwords safe and handy, including passwords to patient portals.
- Having a supply of necessary prescriptions and being prepared to safely store and transport medications if an evacuation is necessary.
- Creating a disaster kit containing items such as a first aid kit, flashlight and batteries, nonperishable food, water, emergency documents and other necessities. The Texas Ready website provides a helpful checklist to help families gather and store the recommended items. For a link, see the Appendix at the end of this course.
- Planning for how to shelter in place as well as how to evacuate, if necessary. This can include identifying public transportation options, evacuation routes and keeping vehicle fuel tanks filled during storm season.
- Considering how to transport family with mobility issues, as well as how to handle pets or other animals.
Medical offices can provide handouts of sample disaster plans to patients and families. See the Appendix for resources from Texas Ready.
A Trauma-informed Approach to Disaster Planning
Families in your practice may have experienced flood, fire, disease or other traumatic events. For them, disaster preparedness may be a sensitive topic that evokes memories of previous hardship. Following are some tips for taking a trauma-informed approach to discussing disaster planning:
- Create a safe space and emphasize confidentiality. “I encourage all my families to develop a disaster plan they feel comfortable with. I’m here to help with information and resources.”
- Sit down and address children and families at eye level, rather than standing. Sitting face-to-face makes the consultation feel more collaborative and encourages children and adolescents to participate in their own health and safety planning
- Offer to discuss disaster preparedness privately with parents to avoid alarming young children.
- Normalize fears and trauma. “Your experience with the flood sounds very difficult. I’m sorry you had to deal with it, and that you are still feeling the effects. Is there anything I can do to help you be prepared if another flood comes?”
- Discuss things collaboratively rather than authoritatively. “How can I help you?” or“How can I support you?” rather than, “You need to do (this and that).”
- Consider families’ individual needs and experiences, such as cultural and language differences which may limit or influence questions. Allow time for and solicit questions and provide families with contact information in case they have questions later.
Family-Centered Communication
Some families in your practice may be unfamiliar with the concept of disaster preparedness and may need additional assistance to understand the importance and components of a family disaster plan. As with all patient communications, consider a child or family’s communication style, language and cultural needs when addressing disaster preparedness.
A recent study revealed that parent-reported culturally sensitive care within pediatric primary care settings was associated with higher-quality well-child care.
Okoniewski, et al. (2022)The U.S. Department of Health and Human Services (HHS) Public Health Emergency website describes five key cultural competencies for disaster preparedness. Health-care providers should review and be able to confidently execute these competencies with children and families:
- Awareness and Acceptance of Difference
- Awareness of One’s Own Cultural Values
- Understanding and Managing the “Dynamics of Difference” in the ways various cultures express and interpret information
- Development of Cultural Knowledge
- Ability to Adapt Activities to Fit Different Cultural Contexts
Link to HHS’s resource for cultural and linguistic competency from the Appendix.
- Special Considerations
Health-care providers can help families plan for ongoing care of children with medical complexities during a disaster. The disaster plan for these children should be more detailed than basic family disaster plans and be tailored to managing and continuing necessary care.
Populations that may need individualized guidance include:
- Children and adolescents who are medically vulnerable, such as those who are immunocompromised, on or receiving treatment for cancer or other ongoing conditions, or using electrically powered medical equipment such as continuous flow oxygen
- Children with physical disabilities and mobility issues who need assistive devices or other support for transportation and activities of daily life
- Children with mental, emotional or behavioral conditions who may require specialized support and help with sensory or communication needs
- Children with auditory or visual impairments who may need additional assistance and modified information and supports
When preparing for disasters, families with members who have special needs should follow the same protocols for a typical family disaster plan. In addition, they should plan for relocating to a safer area and “sheltering in place” when evacuation is not possible or recommended. Some recommended additional planning:
- Identify a support network that can help in case of emergency.
- Register for the State of Texas Emergency Assistance Registry (STEAR), which can help local emergency planning teams anticipate needs in your community.
- Families with deaf members also can register with Accessible Hazard Alert Systems (AHAS) that provides notifications for severe weather, man-made disasters, public health emergencies and Amber alerts. Alerts for Austin/Travis County, Fort Worth, Houston and San Antonio are available. Links for each city’s system are provided in the Appendix.
- Identify accessible transportation that will be available if evacuation is recommended. Parents can contact their local transportation authority to inquire about arrangements and options.
- Families of children getting regular medical treatment such as infusions or dialysis should identify more than one location at which they could receive services.
- Families with children who depend on medical equipment that runs on electricity should contact the local utility to request priority restoration of power after an outage. They should also explore their options for keeping the equipment running during a power outage, such as locating power sources (such as hospital facilities or other locations with prioritized electrical service) or using batteries or generators.
- Children with medical conditions should wear a medical ID bracelet or carry a medical ID card so emergency responders can help quickly if necessary.
- Children with developmental or communication disorders should have an easy-to-see wearable form of ID such as a bracelet or shoe tags so emergency providers can help quickly if necessary and can help children locate their families if they become separated.
- Children with a history of wandering or who are at higher risk of drowning should be monitored more closely. Discuss with families how they can reduce the risk of wandering during a disaster by using locks or alarms on doors, for example. Families can also consider types of tracking devices for their children. See the Appendix for the Big Red Safety Toolkit designed for families of individuals with autism spectrum disorder.
- If assistive devices are used, such as communication or visual supports, recommend that they be kept in an easily accessible location in case of evacuation.
Family Disaster Planning for Children with Special Needs
Children with autism spectrum disorder and other developmental delays will benefit from additional planning for a disaster or evacuation. Tips to keep these children safe include:
- Call the American Red Cross to see if any shelters are specifically set up for individuals with special needs.
- Take precautions to reduce risks to a child or loved one who is prone to wandering.
- Take a copy of a child’s Individualized Education Program, which is a federal document and can more easily help a child get back on track if they must relocate or attend another school.
- Consider ways to ease anxiety and help the child through unexpected changes, such as using a social story and providing comfort items.
See the Appendix for links to more resources about disaster planning for children with special needs.
- Resources
The Texas Ready program was designed to be an all-inclusive resource for household disaster preparedness. The Texas Ready website is available in English and Spanish, and viewers can access a wealth of online tools and tips as well as downloadable documents. There are also videos in American Sign Language. The website encourages individuals to think about their own situations and take precautions based on their circumstances. Viewers go through the steps to get informed, make a plan, build a kit and prepare their household before a disaster.
One of the Texas Ready resources is the Emergency Preparedness Activity Book. This children’s book is available in English and Spanish and provides a range of activities so children can learn about different types of disasters in their community. The activities help children learn what to do during emergencies, such as storms and house fires, as well as how to stay healthy. The book also covers mental and behavioral health, including recommended coping mechanisms for children during stressful situations. The activity book is designed to promote discussion with members of the household about being prepared for and responding to disasters.
In addition, the national Ready Kids web pages—part of Ready.gov from the U.S. Department of Homeland Security—have developmentally appropriate tools to help children to build emergency kits and understand disasters. Health-care providers can share these resources with families. Find links in the Appendix.
STEAR Registration for Special Populations
The State of Texas Emergency Assistance Registration (STEAR) is a free registry that can help state emergency responders anticipate and respond to the needs of vulnerable individuals in their area. Registration does NOT guarantee specific services and support.
Participating counties use data collected by STEAR to inform their emergency response for individuals with:
- Disabilities
- Medical complexities
- Access and functional needs such as:
- Limited mobility
- Communication barriers
- Need for additional medical assistance during an emergency
- Transportation assistance
- Personal care assistance
Families can complete the free, confidential registry by calling 211 or by filling out an online or written form to be faxed. Health-care providers can also offer printed registration forms and assistance to help families register. Find a link to STEAR registration in the Appendix.
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