Office of Operations
21st Century Operations Using 21st Century Technologies

Evacuating Populations With Special Needs

Routes to Effective Evacuation Planning Primer Series


This primer includes the following annexes:

  1. Glossary and Acronyms
  2. Legislation, Regulations, and Policy
  3. Evacuation Checklist
  4. Sample Worksheet for Trip Times
  5. Congregate and Residential Care Facilities Case Studies
  6. References and Resources

Annex 1: Glossary and Acronyms

Per the Americans with Disabilities Act (see below), having the legally required features and/or qualities that ensure entrance, participation, and usability of places, programs, services, and activities by individuals with a wide variety of disabilities.
ADA Definition of Persons with Disabilities
According to the ADA, persons with disabilities are a protected class. An individual is defined as someone with a disability if they: (1) have a physical or mental impairment that substantially limits a major life activity; (2) have a record of such an impairment; and/or (3) are regarded as having such an impairment.
Animal Emergency Response Network
Agency for Healthcare Research and Quality
Advanced Life Support
Vehicles that transport people with disabilities or those with medical conditions. Ambulettes accept Medicaid, Medicare, and other private insurance for travel reimbursement to specific locations such as from a client’s home to a dialysis center and then back home. Ambulettes can take several clients, whereas ambulances, in general, hold one patient for transport to a hospital.
Americans with Disabilities Act (ADA)
Passed in 1990, the ADA is civil rights legislation that protects individuals with disabilities. It guarantees equal opportunity for individuals with disabilities in public accommodations, employment, transportation, state and local government services, and telecommunications.
Animal Welfare Act (P.L. 89-544)
Enacted in 1966, Public Law 89-544, commonly referred to as “The Animal Welfare Act” authorizes the Secretary of Agriculture to regulate transport, sale, and handling of dogs, cats, nonhuman primates, guinea pigs, hamsters, and rabbits intended to be used in research or “for other purposes.” It requires licensing and inspection of dog and cat dealers and humane handling at auction sales.
Agency on Aging
Animal and Plant Health Inspection Service (US Department of Agriculture)
American Red Cross
American Sign Language
American Society for the Prevention of Cruelty to Animals
Assistive Device
Assistive devices are tools, equipment, or products that can help people perform tasks associated with daily living and/or manage specific medical conditions or disabilities. [88] Assistive devices can range from hearing aids to computer programs to more simple devices such as a “reacher.”
Automatic Vehicle Location (AVL)
AVL is a computer-based vehicle tracking system. For transit, the actual real-time position of each vehicle is determined and relayed to a control center. Actual position determination and relay techniques vary, depending on the needs of the transit system and the technologies employed. (Institute of Transportation Studies at the University of California and Caltrans)
American Veterinary Medical Association
Basic Life Support
County Animal Response Team
Citizens’ Band (radio)
Centers for Disease Control
Commercial Driver’s License
Community Emergency Response Team
Closed-Circuit Television (CCTV)
CCTV is a television in which the video signals are transmitted from one or more cameras by cable to a restricted set of monitors. (Oxford English Dictionary)
Changeable Message Sign (also known as VMS or DMS)
Cognitive Disabilities
Cognitive disabilities can vary as much as sensory or mobility situations. Cognitive disabilities can be temporary such as the impact of a stroke or brain injury, as permanent as a cognitive development disability such as mental retardation, or as fluctuating as an individual going through early stages of Alzheimer’s or other types of dementia.
Congregate and Residential Care Facilities (CRCFs)
CRCFs include nursing homes, assisted living centers, drug treatment centers, group homes, residential homes, foster homes, adult and childcare facilities, etc.
Congregate Care Like-to-Like Sheltering
This type of sheltering occurs when evacuees are moved from one congregate care facility to other congregate care facilities that provide an equal level of care.
Cardiopulmonary Resuscitation
Custodial Care
A widely defined term that includes situations involving those such as prisoners or daycare attendees.
Department of Homeland Security
Disaster Mortuary Operational Response Team
Dynamic Message Sign (also known as VMS or CMS)
Department of Justice
Department of Transportation
Durable Medical Equipment (DME)
DME is medical equipment that a person needs to function on a daily basis such as oxygen tanks, wheelchairs, orthotics, and prosthetics.
Emergency Alert System (EAS)
The EAS is designed to provide the President with a means to address the American people in the event of a national emergency. Beginning in 1963, the President permitted state and local emergency information to be transmitted using the system. Since then, local emergency management personnel have used the EAS to relay local emergency messages via broadcast stations, cable, and wireless cable systems. In October 2005, the Federal Communications Commission expanded the EAS rules to require EAS participation by digital television broadcasters, digital cable television providers, digital broadcast radio, digital audio radio service, and direct broadcast satellite systems. (
Emergency Management Agency (EMA)
An EMA may also be known as an Office of Emergency Management (OEM), as an Office of Emergency Services (OES), or by a similar name. It is generally described as a state or local government agency that provides support to the local community in response to an emergency situation.
Emergency Operations Center (EOC)
The EOC is an established location/facility in which local and state staff and officials can receive information pertaining to an incident and from which they can provide direction, coordination, and support to emergency operations. Also, this is where the decision makers and support agencies will report to manage the evacuation.
Emergency Support Function (ESF)
The federal government groups most of its resources and capabilities, and those of certain private-sector and non-governmental organizations, under ESFs. ESFs align categories of resources and provide strategic objectives for their use. They use standardized resource management concepts such as typing, inventory, and tracking to facilitate the dispatch, deployment, and recovery of resources before, during, and after an incident. Support agencies are assigned based on the availability of resources in a given functional area. ESFs provide the greatest possible access to federal department and agency resources regardless of which agency has those resources. 
Emergency Medical Services
Emergency Support Function-1 (also referred to as “Transportation Support Function)
Emergency Support Function-6 (also referred to as “Mass Case Support Function”)
Emergency Support Function-7 (also referred to as “Logistics Management and Resource Support Function”)
Emergency Support Function-8 (also referred to as “Health and Medical Services Support Function”)
Executive Order 13347
On July 22, 2004, President Bush signed Executive Order 13347 to strengthen emergency preparedness with respect to individuals with disabilities. This Executive Order directs the federal government to address the safety and security needs of people with disabilities in emergency situations including natural and man-made disasters.
Frequently Asked Questions
Federal Communications Commission
Federal Emergency Management Agency
Federal Highway Administration
Federal Transit Administration
General Accountability Office
Governor’s Division of Emergency Management
General Population Shelter
General population shelters support individuals who can independently support their own needs, including individuals who are with their own caregivers. General population shelters should be, but are not always, accessible for those with mobility disabilities (such as providing entrance ramps, accessible bathrooms, and passageways).
Geographic Information System (GIS)
GIS is a system for creating, storing, analyzing, and managing spatial data and associated attributes. It is a computer system capable of integrating, storing, editing, analyzing, sharing, and displaying geographically referenced information.
Global Positioning System (GPS)
The GPS is a US space-based radio navigation system that provides reliable positioning, navigation, and timing services to civilian users on a continuous worldwide basis—freely available to all. For anyone with a GPS receiver, the system will provide location and time. GPS provides accurate location and time information for an unlimited number of people in all weather, day and night, anywhere in the world.
Hazardous Materials
Health and Human Services
Highway Advisory Radio (HAR)
HAR is used to broadcast information to motorists in a localized area and provide more information than can often be communicated with a VMS.
Health Insurance Portability and Accountability Act
Homeless Populations
According to the National Coalition for the Homeless (NCH), homelessness can be either permanent or temporary with some families and individuals moving in and out of homelessness. The NCH estimates that there are some 3.5 million people in the United States who are homeless, but cautions that the number is realistically higher because of restraints on how to define and count the homeless populations. These restraints include the transient nature of the homeless population, difficulty with data collection methodologies, and locating people who are homeless as they often stay in cars or “make-shift” housing such as tents or boxes.
Household Pet
A household pet is defined as a domesticated animal, such as a dog, cat, bird, rabbit, rodent, or turtle, that is traditionally kept in the home for pleasure rather than commercial purposes, can travel in commercial carriers, and be housed in temporary facilities. Household pets do not include reptiles (except turtles), amphibians, fish, insects/arachnids, farm animals (including horses), and animals kept for racing purposes.
Sheltering at hospitals should be reserved only for the most critical patients who require specialized, skilled care on a regular basis, often those whose condition is likely to deteriorate quickly during an emergency.
High Occupancy Vehicle
Humane Society of the United States
Interagency Coordinating Council on Emergency Preparedness and Individuals with Disabilities
Intelligent Transportation Systems (ITS)
ITS encompass a broad range of wireless and wireline communications-based information and electronics technologies. One of the ways that DOT officials are responding to the need for information is through the application of ITS technologies.
Joint Commission on the Accreditation of Healthcare Organizations
Miami Jewish Home and Hospital for the Aged
Metropolitan Planning Organization
Mentally Retarded/Developmentally Delayed
Mutual-Aid Agreement
A written agreement between agencies and/or jurisdictions that they will assist one another on request by furnishing personnel, equipment, and/or expertise in a specified manner. The primary objective is to facilitate rapid, short-term deployment of emergency support prior to, during, and/or after an incident.
National Incident Management System (NIMS)
A system mandated by Homeland Security Presidential Directive 5 that provides a consistent nationwide approach for governments, the private sector, and non-governmental organizations to work effectively and efficiently together to prepare for, respond to, and recover from domestic incidents, regardless of cause, size, or complexity.
National Response Framework (NRF)
The NRF is a guide to how the nation conducts all-hazards incident management. It is built upon flexible, scalable, and adaptable coordinating structures to align key roles and responsibilities across the nation. It is intended to capture specific authorities and best practices for managing incidents that range from the serious but purely local to large-scale terrorist attacks or catastrophic natural disasters.
National Council on Disability
National Coalition for the Homeless
National Disaster Medical System
National Fire Protection Association
National Incident Management System
National Mass Evacuation Tracking System
National Organization on Disability
Non-Governmental Organization (NGO)
NGOs are non-profit entities with an association that is based on the interests of its members, individuals, or institutions and that is not created by government, but may work cooperatively with government. Such organizations serve a public purpose not a private benefit. (DHS NIMS Implementation for Non-Governmental Organizations)
Nationwide Plan Review
National Transportation Safety Board
Office of Emergency Management (can be state or local; also known as EMA)
Older Americans Act of 1965 (OAA)
Originally signed into law in 1965, the OAA created the Administration on Aging and authorized grants to states for community planning and services programs, as well as for research, demonstration, and training projects in the field of aging. Later amendments to the act added grants to area Agencies on Aging for local needs identification, planning, and funding of services, including but not limited to nutrition programs in the community as well as for those who are homebound; programs that serve Native American elders; services targeted at low-income minority elders; health promotion and disease prevention activities; in-home services for frail elders; and those services that protect the rights of older persons such as the long-term care ombudsman program.
Pandemic and All-Hazards Preparedness Act (PAHPA)
PAHPA was passed in 2006 and focuses on public health and medical bioterrorism preparedness as well as all-hazard medical surge capacity. Among many provisions in the Act, a specific section addresses special needs or “at-risk populations” including children, pregnant women, senior citizens, and other individuals who have “special needs.” Under the provisions of this law, the needs of “at-risk” individuals should be taken into account in managing several preparedness initiatives such as the Strategic National Stockpile (SNS) and grants to states.
This is the family of transportation services that falls between the single-occupant automobile and fixed-route transit. Examples of paratransit include taxis, carpools, vanpools, minibuses, jitneys, demand responsive bus services, and specialized bus services for the mobility impaired or transportation disadvantaged.
People with Medical Conditions
Many people throughout the United States may have one or more existing medical conditions, some more severe than others. This primer defines people with medical conditions as individuals who have one or more medical diagnoses that may or may not interfere with activities of daily living, but who may need assistance during an emergency evacuation. If a person with a medical condition becomes debilitated, limited, or otherwise impaired, that person may be protected under the ADA.
People with Mobility Disabilities
Mobility disabilities can range from those who experience difficulty moving to those who use assistive devices such as canes, walkers, wheelchairs, or scooters or who may need to remain in beds or similar conveyances.
People with No Access to a Vehicle
This primer defines people with no access to a vehicle as individuals and families in a community that do not have a car and generally rely on public transportation on a daily basis. Individuals and families may not have a car for several reasons including economic factors, geographic location (i.e., people who live in urban environments may not own a vehicle), health conditions (e.g., those with physical disabilities, some of the very elderly), environmental conscientiousness, and lack of a license.
People with Sensory Disabilities
People with sensory disabilities may experience varying levels of vision impairment or may be deaf or hard-of-hearing. Levels of functioning may vary from blind people who travel easily through urban areas or seniors with macular degeneration who have not acclimated to their declining vision.
Pet Evacuation Transportation Standards Act
Pipeline and Hazardous Materials Safety Administration
Public Service Announcement
Reasonable Accommodations
In general, an accommodation is any change to the rules, policies, procedures, or environment or in the way things are customarily done that enables an individual with a disability to enjoy greater participation. A requested accommodation is unreasonable if it poses an undue financial or administrative burden or a fundamental alteration in the program or service.
Radio Frequency Identification
Safe, Accountable, Flexible, Efficient Transportation Equity Act: A Legacy for Users
State Animal Response Team
Service Animal
A service animal is defined under the ADA as “a guide dog, signal dog, or other animal individually trained to provide assistance to an individual with a disability.” Service animals assist people with disabilities in various activities such as sight (seeing-eye dogs) and hearing (hearing dogs). Often, a service animal enables a person with a disability to live independently.
Service Patrol
Transportation workers dispatched to support law enforcement, fire, and rescue personnel in addressing traffic incidents and other roadway emergencies.
Sign Language Interpreter
A person who has been trained to use a system of conventional symbols or gestures made with the hands and body to help people communicate who are deaf or hard of hearing, or have speech impairments.
Special Needs Evacuation Tracking System
Strategic National Stockpile
Standard Operating Procedure
Special Needs or Medical Needs Shelters or Units
Definitions for special needs or medical needs shelters can vary and depend on the resources available and if jurisdictions have established such a shelter system. Generally, the special needs shelter may be a stand-alone shelter or a special needs unit within the general population shelter. By offering skilled medical staff, medical supplies, specialized equipment, and special dietary provisions, the special needs shelter will provide a higher level of care than at a general population shelter. All special needs shelters must be accessible.
Special Needs Populations
No singular definition of the term “special needs” exists, although the term is widely used within the disaster services and emergency management field and is often primarily focused on persons with disabilities. In fact, the term “special needs” is currently under debate in the disability, healthcare, and emergency management communities. “Special needs” can be narrowly defined or seen as a broad and overarching concept.
Stafford Act
The Stafford Act establishes the Presidential Disaster Declaration system, which triggers federal financial and resource assistance to eligible states and local authorities through FEMA. Through the Stafford Act, FEMA is the designated coordinating agency during federally declared disasters. Although part of DHS since 2003, FEMA remains the federal agency that establishes guidelines and grants for state and local emergency management; however, the state often administers guidelines and grants to local jurisdictions and local jurisdictions are expected to carry out the guidelines.
Target Capabilities List
Transit Cooperative Research Program
Text Telephone (TTY)
TTY is also sometimes called a TDD, or Telecommunication Device for the Deaf. TTY is the more widely accepted term, however, as people who are not deaf also use TTYs. A TTY is a special device that allows people who are deaf, hard of hearing, or speech-impaired to use the telephone to communicate by typing messages back and forth to one another instead of talking and listening. A TTY is required at both ends of the conversation in order to communicate (
Traffic Incident Management
Traffic Control Devices
Traffic control devices can help transportation managers to maximize evacuation efficiency and allow designated vehicles to move more freely on otherwise gridlocked roads. Traffic control devices include traffic signals and signs, pavement markings, ramp meters, ramp gates, reverse lanes, and ITS components.
Traffic Management Center (TMC)
The TMC or Traffic Operations Center (TOC) is the hub of a transportation management system, where information about the transportation network is collected and combined with other operational and control data to manage the transportation network and to produce traveler information. It is the focal point for communicating transportation-related information to the media and the motoring public, a place where agencies can coordinate their responses to transportation situations and conditions. The TMC links various elements of ITS such as variable message signs, closed-circuit video equipment, and roadside count stations, enabling decision makers to identify and react to an incident in a timely manner based on real-time data.
Transfer Trauma
It has been documented that when older people with medical conditions are moved during an evacuation, the chances of “transfer trauma” increase. Transfer trauma can affect patients both mentally and physically. Although transfer trauma is more indicative of the frail elderly, conditions of heat, extreme cold, and high humidity can cause those with chronic conditions to deteriorate quickly. Transfer trauma can result in death and must be taken seriously.
Variable Message Signs (VMS)
VMS, also known as changeable message signs (CMS) or dynamic message signs (DMS), are electronic road signs that display messages to system users.
Veterinary Medical Assistance Team