Summary: ADPH offers online trainings about vulnerable populations and emergency management and a brochure on emergency preparedness for people with special needs. During 2007, the Risk Communication Branch worked with other departmental and statewide partners to address the communication needs of the special population communities, including those persons who were blind, deaf, physically impaired and those with cognitive/developmental disabilities. The branch completed a booklet targeted at those in the state with special needs titled, “Preparing for Special Needs in an Emergency.”

Summary: AZDHS developed guidance on gathering demographic information and risk communication strategies for these populations: blind; deaf and hard of hearing; homeless; elderly; illegal immigrants; border population; low-income; mentally ill; American Indians; non-English speakers; physically disabled; and rural residents. The state asked all counties to identify community partners and form planning committees to address special needs populations during a pandemic, to identify regional resources, to prioritize three focus populations, and to exercise special population plans. The Division of Aging and Adult Services has been involved with emergency management to provide outreach to elderly populations. The Arizona Influenza Vaccine Summit focused extensively on at-risk populations, especially in terms of surveillance and identification, distribution of vaccine, education and outreach.

Summary: The Department of Health’s Emergency Operation Center has been planning for at-risk populations in the current H1N1 pandemic, according to a recent press release.

Summary: Delaware Health and Social Services – Division of Public Health maintains numerous activities on at-risk population planning, including: - conducting emergency preparedness exercises with state-operated nursing facilities- sharing children's health information with first responders via a special needs alert program - establishing a neighborhood Emergency Health Center to provide prophylaxis, triage, and evacuation- holding a conference to address needs of people with impaired mobility, vision, hearing, or other health issues- coordinating a medical interpretercorps

Summary: The Florida Department of Health has a page devoted to disaster preparedness activities for vulnerable populations. Activities and materials include an at-risk population communication guide, an agency capacity assessment tool, a county planning assessment tool, a vulnerable population profile for nearly all of its counties, fact sheets about various at-risk populations, and a community- and faith-based organization capabilities matrix.

Summary: The Department of Public Health Nursing developed the policies: The Role of the PHN in Caring for Persons with Special Needs during Disasters and Emergencies and Guidelines for the Care of Persons with Special Needs during Disasters and Emergencies and conducted training regarding their implementation. Public Health Nursing also created a Pandemic Influenza Guidance for Homeless Shelters document with input from the Governor’s Homelessness Council and several homeless agency collaboratives. The Georgia Disabilities Working Group developed a manual for first responders and standards for shelter accessibility and staffing of special needs shelters.

Summary: HDOH Conducted an Emergency Planning for People with Disabilities Agency Readiness Survey.

Summary: The IDHW pandemic response plan calls for reviewing and updating tribal and special population information annually and identifying high-risk areas and underserved populations.

Summary: The IDPH state pandemic preparedness plan mentions a need to provide health/risk information and develop a plan for activities that meet the needs of special populations. At-risk is defined as: “includes, but is not limited to, people with disabilities, people with serious mental illness, minority groups, the non-English speaking, homeless people, children, and the elderly."

Summary: The ISDH Pandemic Influenza Plan states that documents have been developed to address the needs of special populations such as the homeless, immunocompromised, and maternal/child health needs. It defines at-risk populations as: “members of at-risk populations may have additional needs in one or more of the following functional areas: maintaining independence, communication, transportation, supervision, and medical care. In addition to those individuals specifically recognized as at-risk in the statute, i.e., children, senior citizens, and pregnant women, individuals who may need additional response assistance should include those who have disabilities; live in institutionalized settings; are from diverse cultures; have limited English proficiency or are non-English speaking; are transportation-disadvantaged; have chronic medical disorders; and have pharmacological dependency.”

Summary: The Iowa Department of Public Health has a presentation about emergency planning for people with disabilities that defines at-risk as, “Any individual, group or community whose circumstances create barriers to obtaining or understanding information, or the ability to react as the general population has been requested to proceed during all phases of emergency management. Circumstances that may create barriers include, but are not limited to: age, physical, mental, emotional or cognitive status, cultural, ethnic, religion, language, citizenship or socio-economic status.”

Summary: KDHEKS communicates and shares resources such as encouraging early flu vaccination for vulnerable populations, promoting emergency management information systems that are accessible to all persons, and providing links to selected web sites that feature emergency preparedness informational and materials for special populations.

Summary: The Kentucky Outreach and Information Network provides outreach to at-risk populations.

Summary: In June 2007 the state hosted its second annual “Operation Prepare,” in which staff distributed important information and materials about disaster preparation to vulnerable populations. Staff also conducted a survey in 2008 for people living with disabilities. In addition, they have an at-risk registry and a volunteer program to assist people with disabilities who are in shelters during an emergency.

Summary: The Maryland Department of Health and Mental Hygiene has conducted exercises on how to reach and provide healthcare to the handicapped, elderly, and homeless.

Summary: The Massachusetts Department of Public Health has a Community Emergency Preparedness Information Network (with models for community education programs for deaf and hard-of-hearing). The department's web site includes special population guidance for local boards of health. The definition used for at-risk groups focuses on traditional demographic groups and health conditions.

Summary: MDCH developed a Pandemic Influenza Vaccination Guide which recommends that local planners:• Ensure that information is available in locally spoken languages• Ensure that vaccination clinics are in locations that can be reached via public transportation (and consider that public transportation may be disrupted).• Ensure that the needs of the physically disabled are met (e.g., availability of special needs sections of clinics with wheelchairs and extra chairs, specialized transportation).• Ensure that plans have been made for vaccinating homebound persons.• Ensure that proper communications channels are used to reach populations with special needs.Staff also held a training session in October 2008, "Working with Special Needs Populations during a Disaster."

Summary: The MN DOH maintains materials and links to planning resources geared towards at-risk groups.

Summary: DHSS's pandemic influenza plan contains a chapter about people with special health-care needs. Their Special Health Care Needs Pandemic Flu Subcommittee’s mission is to ensure Missourians with special health care needs in the community are recognized and receive full and equitable access to care.

Summary: The New Jersey Special Needs Advisory Panel (NJSNAP) is an advisory board to the New Jersey Office of Emergency Management on issues affecting special needs population in New Jersey before, during and after a disaster. At-risk populations are defined as: “People with Special Needs are individuals in New Jersey who have a physical or mental condition and/or medical care need who, after exhausting all other resources (family, neighbors, public transportation, etc.), still need assistance for evacuation and/or sheltering before, during and possibly after a disaster or emergency.”

Summary: The NM DOH web site contains a community profile on each New Mexico County that includes information on special populations and their needs. In addition, they have an American Indian Advisory Council that works to eliminate health disparities and guide the health department on important topics.

Summary: NY DOH staff conducted community engagement meetings and focus groups with vulnerable populations that resulted in identifying nine areas of need for at-risk populations during a pandemic. At-risk definition includes the elderly, individuals with disabilities or mental health issues, tribal nations, minority New Yorkers and vulnerable children.

Summary: NC Public Health created a fact sheet on refugee health and pandemic planning, designed a community assessment for Public Health Emergency Response using GIS, and have a planning committee that includes Hispanic/Latino outreach professional and a special needs communicator. They also created a fotonovela on pandemic influenza and funded a Pandemic Influenza Disparities Prevention initiative that led to publication of a report exploring communications issues and other aspects of disparities. Staff also gave a conference presentation on vulnerable populations and pandemic influenza.

Summary: ODH's Influenza Pandemic Response Plan states: “Consideration for the needs of special populations, like the pediatric population, will be addressed.”

Summary: OSDH has an Office of Minority Health that deals with some at-risk groups and works to eliminate health disparities. In addition, they include special needs population planning in their Strategic Planning Criteria Minimum Guidelines document for area hospitals.

Summary: The ODHS pandemic response plan states the flu may adversely affect people with special needs or who live in institutions. Their 2005-2006 communications planning grid recommends keeping special populations informed, using a combination of methods to do so, and developing special materials for each audience.ODHS held a summit on H1N1 response and dedicated a whole section to outreach for at-risk populations.

Summary: A Special Needs Taskforce met for four months to create a toolkit for local public health planners to use in their planning efforts. The task force also came up with tips for local planners in conducting community outreach meetings.