F-13-202 Client Disaster Risk and Emergency Preparedness Plan

🎯 PURPOSE

Describe the process for how to complete the Client Disaster Risk and Emergency Preparedness section on the Emergency Plan/Responsible Party Form and the Client Calendar Plan of Care/Individualized Form

Adara must address the emergency preparedness needs of the clients we serve. Clients who may require assistance during an emergency should have an individualized emergency plan that reflects their specific needs, abilities, available supports, and risks. The plan should be practical, individualized, easy to follow, reviewed, and updated when the client's needs or circumstances change.

🔄 PROCESS

Emergency Plan/Responsible Party Form:

1. Essential/Non-Essential Services: This section indicates what the plan will be if Adara cannot provide the scheduled visit at the scheduled time. Choose ONE category:
   • Non-Essential Services: Choose this when the scheduled service can safely be delayed or rescheduled without creating an immediate medical or safety concern for the client. “Non-Essential” does not mean the visit or service isn't medically necessary or important. It only means that missing the scheduled visit would not create an immediate medical or safety concern.
     • Select what should happen if Adara cannot make the visit:
       • Notify the client and reschedule the appointment OR
       • Arrange another reasonable alternative- write the alternative on the line provided. Example: Routine therapy visit that can safely be rescheduled. Notify daughter POA and reschedule

• Essential Services: Choose this when the service must be completed at the scheduled time for medical or safety reasons and cannot safely wait until another visit can be scheduled.
  • Identify the backup plan:
    • Primary Caregiver will perform the essential service
    • Emergency services/evacuation, when applicable OR
    • Other- clearly describe the backup plan. Example: Client has a time-sensitive wound care treatment that cannot be delayed and a trained caregiver (daughter) is available to provide it in an emergency

2. Identify the Support Persons for the client:

• Emergency Contact: Who do we CALL in an emergency or when we cannot reach the client?
• Responsible Person: Who is AUTHORIZED to be involved in healthcare decisions/communication?
• Primary Caregiver: Who actually HELPS WITH CARE?
• Financially Responsible Person: Who is responsible for RECEIVING/PAYING bills and copayments.

Client Calendar/Individualized Plan of Care Form:

1. Client Disaster Risk Level (Acuity Status) in the Event of an Emergency: Select the risk level based on what could happen to the client if the scheduled services are interrupted during an emergency or disaster. Consider the client's current condition, required services, level of dependence, available support, consequences if services are interrupted, etc..     
   1. High Risk: Services cannot safely be interrupted. A missed/delayed visit could result in significant harm, deterioration, or hospitalization, and adequate backup support is not available. Client is incapable of evacuating or initiating emergency plan.
   2. Average Risk: Services can safely be delayed for a short period (generally 48–72 hours). Some assistance or monitoring is needed, but temporary caregiver or other support is available. Client is unable to leave the home in an emergency, but the caregiver and/or client can initiate the emergency plan and can communicate with others to assist with the evacuation.
   3. Low Risk: Services can safely be delayed beyond 72 hours. The client is stable and can meet basic needs independently or with available caregiver/support. Client is able to evacuate either independently or readily with the assistance of a caregiver.

2. Review Emergency Preparedness Information: Explain to the client and/or caregiver that the Adara Client Handbook contains the Individualized Emergency Preparedness Plan section with important emergency preparedness information and recommendations.
   1. Review the applicable information with the client/caregiver and encourage them to keep the Client Handbook accessible for reference during an emergency.

   2. Reference: Client Handbook, Page 40.

      

3. Immediate Evacuation Plan: Document how the client will safely leave the home if an emergency requires immediate evacuation, such as a fire, gas leak, structural damage, flooding, or evacuation order.
   1. Include how the client will exit the home, whether assistance is needed, who will provide that assistance, where the client will initially go, and if medications, oxygen, medical equipment, or other essential supplies are needed during the evacuation.
   2. Examples may include:
      • Client will independently exit through the front door and drive to daughter's home.
      • Requires assistance of another person to evacuate. Contact Primary Caregiver to evacuate and transport to his home.
      • Client requires assistance from spouse to transfer into wheelchair and exit through accessible ramp outside the front door. Will stay with daughter.
      • Client will call 911 if unable to evacuate safely without assistance and stay in a local shelter.
      • Caregiver will transport client to designated evacuation location.
      • Client will need life-sustaining medical equipment for suctioning and portable oxygen tank and require transport to a skilled nursing facility. 
      • The client's Emergency Contact (daughter) will assist with evacuation and provide shelter. She will ensure the medication box and can temporarily set up medications until client can return home.

4. Shelter in Place: Document the client's plan for remaining safe in the home during emergencies when evacuation is not recommended (e.g., tornado, severe winter storm, power outage, or hazardous weather). Include where the client will shelter, available emergency supplies, medical equipment needs, backup power plans (if applicable), any medical considerations, and who will check on the client.
   1. Examples may include:
      • Client will shelter in basement during tornado warnings
      • Daughter will check on client by phone daily during severe weather
      • Client uses oxygen and has backup oxygen tanks available
      • The client's Primary Caregiver (daughter) is available and able to complete the medication set-up until Adara services can resume

5. Contingency Plan if Residence is Not Available: Document the client's plan if the home becomes temporarily or permanently uninhabitable due to fire, flooding, storm damage, or another emergency.
   1. Include where the client will stay, who will assist with transportation, and how ongoing medical needs and home health services will be coordinated.
   2. Examples may include:
      • Client will stay with son (Responsible Person) who will manage all essential care until able to return home.
      • Assisted living facility identified as temporary placement if home is unsafe.
      • Emergency shelter will be used if family is unavailable.
      • Client will notify Adara once relocated so services can be coordinated at the temporary location.

5. Durable Medical Equipment (DME) Supplier Information: Identify medical equipment the client relies upon and document the applicable supplier and emergency contact information. Pay particular attention to life-sustaining or electrically powered equipment.
   1. Determine whether the client has an appropriate contingency plan if electricity is unavailable or equipment becomes damaged, inaccessible, or nonfunctional.
   2. Examples of Equipment:
      • Oxygen
      • Hospital Bed
      • Wheelchair
      • Walker
      • Suction
      • Feeding Pump
      • Ventilator
      • CPAP/BiPAP
      • Lift

📅 Effective: 10/6/2026  | 🛠️ Revised:  |  ✅ Approved: RE