Guidance on Planning for 

Integration of Functional 

Needs Support Services in 

General Population Shelters

November 2010
2

This guidance was created for FEMA by

BCFS Health and Human Services, San Antonio, Texas; www.bcfs.net; 1-800-830-2246
Guidance on Planning for 

Integration of Functional Needs 

Support Services in General 

Population Shelters

Contents

Page Section

7 1. Purpose

7 2. Disclaimer

8 3. Scope

8 3.1. Definition

8 3.2. FNSS Planning

9 3.3. Premise

10 3.4. Legal Foundation for FNSS Guidance

12 3.5. Legal Authorities and References

13 4. FNSS Guidance

15 4.1. Key Considerations in Planning for Shelter Set-Up

15 4.1.1. Planning in Advance for FNSS

16 4.1.2. Stakeholder Coordination

17 4.1.3. Planning Shelter Capacity

17 4.1.4. Identifying Shelter Sites/Facilities

18 4.1.5. Evaluating the Shelter
18 4.1.6. Selecting the Shelter 

19 4.1.7. Equipping and Supplying the Shelter

21 4.1.8. Locating Services

23 4.1.9. Staffing the Shelter

24 4.1.10. Assessment Teams

25 4.1.11. Shelter Layout

25 4.1.12. Shelter Intake

27 4.2. Key Considerations in Planning for Shelter Operations 

28 4.2.1. Dietary

28 4.2.2. Service Animals

30 4.2.3. Communication 

31 4.2.4. Bathing and Toileting Needs

32 4.2.5. Quiet Area

32 4.2.6. Mental Health Services

32 4.2.7. Medical and Dental Services

34 4.2.8. Medication 

35 4.2.9. Transportation Services

37 4.3. Key Considerations in Planning for Transition/Recovery

37 4.3.1. Transitioning Back to the Community

38 4.3.2. Closing the Shelter

40 5. Acronyms

41 6. Glossary

44 7. Operational Tools

45 8. Appendices
5

Acknowledgements

FNSS Review Panel Members that helped direct and 

define this guidance document

FEMA • Mass Care Section

• Office of Disability Integration and Coordination

• Volunteer Agency Liaison 

• Faith Based Office

• Office of Chief Council

• Region I 

• Region VI 

• Region X

HHS • ESF 8 Office of the Assistant Secretary for Preparedness and Response ASPR

• ESF 6 Administration for Children and Families

DHS• Office for Civil Rights and Civil Liberties 

DOJ• Disability Rights Section, Civil Rights Division

American Red Cross • Direct Services

• Mass Care

• Disaster Health Services

National Council on Disability

National Council on Independent Living

National Disability Rights Network

Center for Disability and Health Policy

Rhode Island Department of Health • Center for Emergency Preparedness & Response (CEPR)

Florida Statewide Disability Coordinator,

Division of Emergency Management

California Emergency Management Agency,

Office for Access and Functional Needs
6
7

Functional Needs

Support Services

Guidance on Planning for Integration of Functional 

Needs Support Services in General Population 

Shelters

1. Purpose

The purpose of this document is to provide planning guidance that can be incorporated into existing 

shelter plans to State emergency managers and shelter planners to meet access and functional needs 

in general population shelters. This document provides guidance to assist emergency managers 

and shelter planners in understanding the requirements related to sheltering children and adults 

with functional support needs in general population shelters. Functional Needs Support Services 

(FNSS) and the guidance provided are designed to assist in the planning and resourcing of sheltering 

operations whether government, NGO, faith- or private-based to meet the access and functional 

needs of children and adults. These guidelines identify methods of achieving a lawful and equitable 

program through the delivery of FNSS for children and adults. 

 

2. Disclaimer

This guidance is not designed to establish local government as the single shelter operator or 

establish a new “tier” of sheltering. It is not intended to establish new legal obligations, alter existing 

obligations, or constitute a legal interpretation of the statutes that are the basis of the guidance 

materials. The guidance is not meant to duplicate or cover all requirements found in existing or 

potential shelter plans or SOP’s. This is simply a resource for integrating FNSS into the general 

shelter planning process and/or existing documents. Listing an agency or organization’s processes/ 

procedures as an operational tool in this guidance does not constitute a recommendation or 

endorsement of the resource. In addition, information presented in an operational tool may have been 

summarized, modified and/or combined with other cited sources.
8

3. Scope

This guidance has been developed to support local, tribal, State and Federal governments to integrate 

children and adults with and without disabilities who have access and functional needs into every 

aspect of emergency shelter planning and response. It is intended to be used in conjunction with 

general population shelter Standard Operating Procedures (SOP) to ensure that all shelter residents 

benefit equally from programs, services, and activities. It provides a context for FNSS integration in 

light of other existing plans and describes a process to use in any planning effort. These guidelines 

are scalable and can be applied to urban, suburban, and rural localities with multiple or limited 

resources. 

Children and adults with disabilities have the same right to services in general population shelters 

as other residents. Emergency managers and shelter planners have the responsibility of planning 

to ensure that sheltering services and facilities are accessible. The decisions made in the planning 

process determine whether integration or segregation occurs during response. Although the FNSS 

guidance is geared toward emergency managers and shelter planners, it is a document that can be 

utilized as a shelter planning tool in local communities.

Throughout this document “State” is used to refer to a U.S. State, tribal government, U.S. territory 

and the District of Columbia.

3.1. Definition

Functional Needs Support Services (FNSS) are defined as services that enable individuals to maintain 

their independence in a general population shelter. FNSS includes:

• reasonable modification to policies, practices, and procedures

• durable medical equipment (DME)

• consumable medical supplies (CMS)

• personal assistance services (PAS)

• other goods and services as needed

Children and adults requiring FNSS may have physical, sensory, mental health, and cognitive and/or 

intellectual disabilities affecting their ability to function independently without assistance. 

Others that may benefit from FNSS include women in late stages of pregnancy, elders, and people 

needing bariatric equipment. 

 

3.2. FNSS Planning 

Planning for FNSS in general population shelters includes the development of mechanisms that 

address the needs of children and adults in areas such as:

• Communication assistance and services when completing the shelter registration process and 

other forms or processes involved in applying for emergency-related benefits and services 

including Federal, State, tribal, and local benefits and services

• DME, CMS, and/or PAS that assist with activities of daily living

• Access to medications to maintain health, mental health, and function

• Available sleeping accommodations (e.g., the provision of universal/accessible cots or beds 

and cribs; the placement, modification, or stabilization of cots or beds and cribs; the provision 

and installation of privacy curtains)

• Access to orientation and way-finding for people who are blind or have low vision
9

• Assistance for individuals with cognitive and intellectual disabilities

• Auxiliary aids and services necessary to ensure effective communication for persons with 

communication disabilities

• Access to an air-conditioned and/or heated environment (e.g. for those who cannot regulate 

body temperature)

• Refrigeration for medications

• Availability of food and beverages appropriate for individuals with dietary restrictions (e.g., 

persons with diabetes or severe allergies to foods such as peanuts, dairy products and gluten)

• Providing food and supplies for service animals (e.g., dishes for food and water, arrangements 

for the hygienic disposal of waste; and, if requested, portable kennels for containment)

• Access to transportation for individuals who may require a wheelchair-accessible vehicle, 

individualized assistance, and the transportation of equipment required in a shelter because of 

a disability

• Assistance locating, securing, and moving to post-disaster alternative housing, which includes 

housing that is accommodating to the individual’s functional support needs (e.g., accessible 

housing; housing with adequate space to accommodate DME; or housing located in close 

proximity to public transportation, medical providers, job or educational facility, and/or retail 

stores)

• Assistance with activities of daily living such as: 

◦ eating

◦ taking medication 

◦ dressing and undressing

◦ transferring to and from a wheelchair or other mobility aid

◦ walking

◦ stabilization

◦ bathing

◦ toileting

◦ communicating

3.3. Premise

Historically, resource gaps have existed in planning for and meeting access and functional needs 

in general population shelters. Many times this has resulted in disparate treatment and the denial 

of full and equal services. The intent of this planning guidance is to ensure that individuals are not 

turned away from general population shelters and inappropriately placed in other environments (e.g., 

“special needs” shelters, institutions, nursing homes, and hotels and motels disconnected from other 

support services). Addressing these gaps benefits the entire community and maximizes resources.
10

3.4. Legal Foundation for FNSS Guidance

The Stafford Act and Post-Katrina Emergency Management Reform Act (PKEMRA), along with 

Federal civil rights laws, mandate integration and equal opportunity for people with disabilities in 

general population shelters. 

To comply with Federal law, those involved in emergency management and shelter planning should 

understand the concepts of accessibility and nondiscrimination and how they apply in emergencies. 

The following are key nondiscrimination concepts applicable under Federal laws, and examples of 

how these concepts apply to all phases of emergency management. 

1. Self-Determination – People with disabilities are the most knowledgeable about their own 

needs.

2. No “One-Size-Fits-All” – People with disabilities do not all require the same assistance and do 

not all have the same needs. 

• Many different types of disabilities affect people in different ways. Preparations should 

be made for people with a variety of functional needs, including people who use mobility 

aids, require medication or portable medical equipment, use service animals, need 

information in alternate formats, or rely on a caregiver.

3. Equal Opportunity – People with disabilities must have the same opportunities to benefit from 

emergency programs, services, and activities as people without disabilities.

• Emergency recovery services and programs should be designed to provide equivalent 

choices for people with disabilities as they do for people without disabilities. This 

includes choices relating to short-term housing or other short- and long-term disaster 

support services.

4. Inclusion – People with disabilities have the right to participate in and receive the benefits of 

emergency programs, services, and activities provided by governments, private businesses, 

and nonprofit organizations. 

• Inclusion of people with various types of disabilities in planning, training, and evaluation 

of programs and services will ensure that all people are given appropriate consideration 

during emergencies.

5. Integration – Emergency programs, services, and activities typically must be provided in an 

integrated setting. 

• The provision of services such as sheltering, information intake for disaster services, and 

short-term housing in integrated settings keeps people connected to their support system 

and caregivers and avoids the need for disparate services facilities.

6. Physical Access – Emergency programs, services, and activities must be provided at locations 

that all people can access, including people with disabilities.

• People with disabilities should be able to enter and use emergency facilities and access 

the programs, services, and activities that are provided. Facilities typically required to be 

accessible include: parking, drop-off areas, entrances and exits, security screening areas, 

toilet rooms, bathing facilities, sleeping areas, dining facilities, areas where medical care 

or human services are provided, and paths of travel to and from and between these areas.

7. Equal Access – People with disabilities must be able to access and benefit from emergency 

programs, services, and activities equal to the general population.

• Equal access applies to emergency preparedness, notification of emergencies, evacuation, 

transportation, communication, shelter, distribution of supplies, food, first aid, medical 

care, housing, and application for and distribution of benefits. 
11

8. Effective Communication – People with disabilities must be given information that is 

comparable in content and detail to that given to the general public. It must also be accessible, 

understandable and timely.

• Auxiliary aids and services may be needed to ensure effective communication. These 

resources may include pen and paper; sign language interpreters through on-site or video; 

and interpretation aids for people who are deaf, deaf-blind, hard of hearing or have 

speech impairments. People who are blind, deaf-blind, have low vision, or have cognitive 

disabilities may need large print information or people to assist with reading and filling out 

forms.

9. Program Modifications – People with disabilities must have equal access to emergency 

programs and services, which may entail modifications to rules, policies, practices, and 

procedures.

• Service staff may need to change the way questions are asked, provide reader assistance to 

complete forms, or provide assistance in a more accessible location.

10. No Charge – People with disabilities may not be charged to cover the costs of measures 

necessary to ensure equal access and nondiscriminatory treatment.

• Examples of accommodations provided without charge to the individual may include 

ramps; cots modified to address disability-related needs; a visual alarm; grab bars; 

additional storage space for medical equipment; lowered counters or shelves; Braille 

and raised letter signage; a sign language interpreter; a message board; assistance in 

completing forms or documents in Braille, large print or audio recording.

See FEMA: IV. Non-discrimination Principles of the Law; http://www.fema.gov/oer/reference/

principles.shtm

 

The Americans with Disabilities Act of 1990 (ADA), the Rehabilitation Act of 1973 (RA), and the 

Fair Housing Act (FHA), their regulations and agency guidance, as well as State counterparts, among 

others, define the scope of FNSS. These hallmarks of equal opportunity for people with disabilities 

include:

• The implementation and execution of a general policy of nondiscrimination on the basis of 

disability

• Sheltering persons with disabilities in the most integrated setting appropriate to the needs of 

the person, which in most cases is the same setting people without disabilities enjoy

• Reasonable modifications of policies, practices, and procedures to ensure nondiscrimination, 

with reasonableness judged in light of nondiscrimination principles applied in emergent 

circumstances

• The provision of auxiliary aids and services to ensure effective communication, with primary 

consideration of the aid or service given to the person with a disability

• Elimination of eligibility criteria, discriminatory administrative methods, paternalistic safety 

requirements, and surcharges where discrimination results

• The selection of accessible sites for the location of general population emergency shelters, 

the construction of architecturally compliant mass care shelters and elements, and required 

physical modifications to ensure program accessibility in existing facilities
12

3.5. Legal Authorities and References

ADA Best Practices Tool Kit for State and Local Governments, Chapter 7, Emergency Management 

under Title II of the ADA (2007), Addenda 1-3, and the Introduction to Appendices 1 and 2 (Attached 

as Exhibit 1); Titles II, III, and V of the Americans with Disabilities Act of 1990, 42 U.S.C. §§ 12101-

12103, 12131-12134, 12181-12188, and 12201-12213, as amended by the ADA Amendments Act 

of 2008. Nondiscrimination on the Basis of Disability in State and Local Government Services, 

28 C.F.R. pt. 35. Nondiscrimination on the Basis of Disability by Public Accommodations and in 

Commercial Facilities, 28 C.F.R. pt. 36. The Americans with Disabilities Act Title II Technical 

Assistance Manual (1993) and Supplement (1994). The Americans with Disabilities Act Title III 

Technical Assistance Manual (1993) and Supplement (1994). 

Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. §§ 794, as amended. Enforcement of 

Nondiscrimination on the Basis of Handicap in Programs or Activities Conducted by the Federal 

Emergency Management Agency, 44 C.F.R. pt. 16. Enforcement of Nondiscrimination on the Basis 

of Handicap in Programs or Activities Conducted by the Department of Justice, 28 C.F.R. pt. 39. 

Nondiscrimination on the Basis of Handicap in Programs or Activities Receiving Federal Financial 

Assistance, 45 C.F.R. pt. 84 (Department of Health and Human Services). Nondiscrimination on 

the Basis of Handicap in Programs or Activities Receiving Federal Financial Assistance, 34 C.F.R. 

pt. 104 (Department of Education). Nondiscrimination Based on Handicap in Federally Assisted 

Programs and Activities of the Department of Housing and Urban Development, 24 C.F.R. pt. 8.

Title VIII of the Civil Rights Act of 1968 (“Fair Housing Act”), as amended, 42 U.S.C. §§ 3601-3631. 

Discriminatory Conduct Under the Fair Housing Act, 24 C.F.R. pt. 100.

The Architectural Barriers Act of 1968, as amended, 42 U.S.C. §§ 4151-4157. Construction and 

Alteration of Public Buildings, 41 C.F.R. pt. 101-19.

The Homeland Security Act of 2002, 6 U.S.C. §§ 101-557, as amended.

The Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C. §§ 5121-5206, as 

amended. Federal Disaster Assistance, 44 C.F.R. pt. 206.

The Post-Katrina Emergency Management Reform Act, 6 U.S.C. § 761(d), as amended.

Emergency managers and shelter planners are encouraged to investigate their applicable State laws.
13

4. FNSS Guidance

This document outlines common scenarios that general population shelter planners and operators may 

encounter during emergencies and disasters, and presents guidance on providing an integrated, nondependent, nondiscriminatory environment, so people with and without disabilities may benefit from 

the same sheltering program.

The operational tools in this document are excerpts and examples taken from various agency and 

jurisdictional documents throughout the United States. While they are not meant to dictate a State’s 

policies or procedures, they do present ideas and practices that can be adapted to fit each State’s 

specific needs.
14
15

4.1. Key Considerations In 

Planning For Shelter Set-Up

4.1.1. Planning in Advance for FNSS

The importance of advanced planning in developing and implementing FNSS in general population 

shelters cannot be overstated. Throughout the document this principle will be repeated again and 

again to emphasize that FNSS cannot wait to be identified and put into place once an emergency or 

disaster occurs. 

Often, it is assumed that during a disaster, children and adults requiring FNSS must be housed 

in a medical special needs shelter. Children and adults with access and functional needs do not 

necessarily have medical conditions and typically do not require the care that medical shelters 

provide. Diverting to medical shelters can result in the separation of individuals with disabilities 

from those associated with them such as family, friends, neighbors and caregivers. In addition, 

inappropriate placement can jeopardize the health and safety of the entire community by creating 

unnecessary surges on emergency medical resources. 

A one-size-fits-all approach to shelter planning does not work. (See FEMA: IV.Non-discrimination 

Principles of the Law; http://www.fema.gov/oer/reference/principles.shtm). 

Under the Americans with Disabilities Act (ADA), children and adults with disabilities are entitled to 

equal opportunity to participate in programs, services, and activities in the most integrated setting.

 

Historically, shelter facilities may not have met requirements under the Standards for Accessible 

Design, 28 CFR Part 36 (adopted from ADA Architectural Guidelines). Newly constructed or 

recently altered facilities are more likely to fully comply with standards for accessible design. The 

decision to open a shelter that violates Federal laws and ADA standards brings with it significant 

challenges to appropriately and safely shelter children and adults with and without disabilities who 

have access and functional needs. 

State, tribal and local governments are responsible for maintaining plans to support emergency 

response. Emergency managers and shelter planners should incorporate the planning considerations 

addressed in this guidance into their existing plans. 
16

Operational Tool #1 Planning Guidance

Comprehensive 

Preparedness Guide 101

A Guide for All-Hazard 

Emergency Operations 

Planning

The FEMA Comprehensive Preparedness Guide, CPG 101 

provides general guidelines on developing Emergency Operations 

Plans (EOPs). It promotes a common understanding of the 

fundamentals of planning and decision making to help emergency 

planners examine a hazard and produce integrated, coordinated, 

and synchronized plans. This guide helps emergency managers in 

State, territorial, local, and tribal governments in their efforts to 

develop and maintain a viable all-hazard EOP.

Source http://www.fema.gov/pdf/about/divisions/npd/CPG_101_V2.pdf

4.1.2. Stakeholder Coordination

All levels of government, working closely with the private sector, share the responsibility of 

providing emergency shelter care to children and adults who need assistance. All citizens expect 

their State and local governments to keep them informed and to provide assistance in the event of an 

emergency or disaster. 

In developing plans that will meet the needs of people requiring FNSS, emergency managers and 

shelter planners should collaborate with all relevant stakeholders including: 

• People requiring FNSS

• Agencies and organizations that provide FNSS

• Agencies and organizations that advocate for the rights of people requiring FNSS

• DME, CMS, PAS, and communication providers

Emergency managers and shelter planners can obtain assistance in identifying stakeholders by 

accessing www.disability.gov. 

The operational tools in this document are excerpts and examples taken from various agency and 

jurisdictional documents throughout the United States. While they are not meant to dictate a State’s 

policies or procedures, they do present ideas and practices that can be adapted to fit each State’s 

specific needs.

Operational Tool #2 Stakeholder Coordination

Sample State 

Guidance to Address 

Functional Needs 

The New Hampshire Functional Needs Guidance includes the names 

and contact information for direct service providers and advocacy 

organizations that work with functional needs populations, such as faithbased organizations, home-healthcare providers, Meals on Wheels, etc. In 

addition, the document suggests that the State and local agencies that may 

be of assistance include the: Developmental Disabilities Council, Area 

Agencies, Governor’s Commission on Disability, Granite State Independent 

Living, Northeast Deaf and Hard of Hearing Services, NH Association 

for the Blind, NH Brain Injury Foundation, Community Action Programs, 

Community Mental Health Centers and NH Office of Minority Health.

Source New Hampshire Functional Needs Guidance – Support Document to the 

State Emergency Operations Plan

http://www.nh.gov/safety/divisions/hsem/stateemergplan/index.html
17

4.1.3. Planning Shelter Capacity 

When anticipating and planning for shelter capacity, emergency managers and shelter planners 

should:

• Be familiar with and committed to meeting ADA requirements for general population care 

shelters

• Know the demographic profile of their community and understand the type of assistance that 

may be required by various populations during an emergency or disaster

• Establish a rigorous public education program with an emphasis on personal preparedness. 

(The program should include information in accessible formats and languages to reach the 

entire community)

• Collaborate with stakeholders (see section above on Stakeholder Coordination)

• Ensure that emergency plans are a “living document” and are updated with a predetermined 

frequency, as well as after any major event

• Establish mutual-aid agreements and memorandums of understanding with neighboring 

communities that can provide additional emergency resources in the event that local shelters 

are destroyed or damaged

Operational Tool #3 Planning Shelter Capacity

Sample of Available 

Information Regarding 

the Estimated Number of 

Children and Adults in Texas 

who have a Disability or 

have Difficulty Performing 

Self-care Activities

In Texas, there are an estimated 2,962,000 people, age 5 and older, 

who have a disability. Texas also has an estimated 579,000 people, 

age 5 and older, who have difficulty performing self-care activities. 

This website presents the disability prevalence data by State or the 

entire U.S. and is broken down by disability type, age, gender, race, 

ethnicity, family income, benefit recipiency, employment, and living 

arrangement.

Source Center for Personal Assistance Services, University of California, 

San Francisco, California

http://www.pascenter.org

Note: Click on Need for PAS, click on Disability Prevalence Data 

from the Current Population Survey (2008-2009)

4.1.4. Identifying Shelter Sites/Facilities

Federal and State laws require that children and adults with disabilities have equal opportunity 

to access emergency programs and services. An assumption might be made that if a building is 

designated as a shelter, it will meet the needs of all individuals as long as it provides a safe place to 

eat, sleep, and take care of personal hygiene needs. However, without modifications, some shelters 

are not appropriate to support the integration of FNSS. Emergency managers and shelter planners 

should ensure that all general population shelters meet ADA requirements, including the standards for 

accessible design and State accessibility codes. 

Operational Tool #4 Locating the Shelter

Priority Site Selection Facilities that have been built or altered since 1992 are more likely to 

comply with the architectural requirements of the ADA

Source ADA Best Practices Toolkit Chapter 7, ADA Checklist for

Emergency Shelters 

www.ada.gov/pcatoolkit/chap7shelterchk.pdf
18

4.1.5. Evaluating the Shelter

Individuals who have the responsibility of selecting shelter sites are often not trained in what 

constitutes an accessible facility. They need information to assist them in evaluating a building 

to determine if it is accessible or can be made accessible expeditiously with few modifications 

and minimal expense. There are individuals in nearly every community who have experience in 

evaluating accessibility (e.g., ADA Consultants, ADA accessibility inspectors, disability-related 

organizations). 

Preliminary analysis of each potential shelter will expedite the elimination of any building with 

extensive barriers.

Operational Tool #5 Evaluating the Shelter-Site Selection Tool

ADA Checklist for 

Emergency Shelters 

Shelters need accessible:

• Entrances

• Routes to all services/activity areas

• Routes within toilet rooms 

• Passenger drop off and pick up areas

• Parking

• Sidewalks and walkways

• Shelter entrances, hallways, and corridors

• Check in/information areas

• Sleeping areas

• Restrooms, showers, and toilet stalls, including portable toilets

• Public telephones

• Drinking fountains

• Eating areas

• Medical first aid areas

• Recreation areas

The checklist provides instructions on taking measurements of the shelter.

Source www.ada.gov/pcatoolkit/chap7shelterchk.pdf; ADA Checklist for 

Emergency Shelters; Appendix 1

4.1.6. Selecting the Shelter

State codes and standards must, at a minimum, meet the Federal requirements, but can be more 

comprehensive. The ADA and other Federal laws, including the Stafford Act, the Rehabilitation 

Act, the Fair Housing Act, and the Architectural Barriers Act, provide affirmative obligations 

and prohibitions of discrimination on the basis of disability. No State or local government, or its 

contractors, may, by law, policy, or contract, provide services below those standards without violating 

Federal law. This does not mean that a State or local government cannot enact laws and ordinances 

or provide services, obligations, and prohibitions that extend beyond these standards to ensure greater 

access. A common example would be to provide twice as many as the required number of accessible 

parking spaces and access aisles.

Since most States and communities have additional codes and standards related to accessibility, 

emergency managers and shelter planners should be sure to identify and comply with these 

requirements as well.
19

If selected as an emergency shelter, a facility with inaccessible features must be made accessible 

before use as a shelter (reference Operational Tools #4 and #5 and Appendix 1).

Plans should include strategies to provide power for services that require a back-up power system in 

an emergency or disaster. It is important to determine if a facility has a source of emergency power 

generation. 

Operational Tool #6 Florida Shelter Selection Checklist

Checklist for 

Emergency 

Shelters

Checklist for emergency shelters reflecting Florida code

Source Americans with Disabilities Act/Florida Accessibility Code

Statewide Disability Coordinator 

Telephone : 850-413-9892 

http://www.floridadisaster.org/documents/ada/emergencyshelterchecklistflorida.pdf 

Operational Tool #7 San Jose California Shelter Assessment Checklist

Checklist for Assessing 

Emergency Shelters 

San Jose California tool for assessing an emergency shelter

Source San Jose Office of Emergency Services

http://www.sanjoseca.gov/emergencyservices

Note: Click on San Jose Disaster Shelter Annex for Vulnerable 

Populations, click on Annex D 

 

4.1.7. Equipping and Supplying the Shelter 

Post-Katrina Emergency Management Reform Act (PKEMRA) requires that children and adults 

with and without disabilities who have access and functional needs must be able to access the same 

programs and services as the general population. 

Despite best efforts and advance planning, some persons will arrive at the shelter without the durable 

medical equipment (DME) and/or medications they require. 

Prior to an emergency or disaster, emergency managers and shelter planners should:

• Include in the State plan a process for locating, purchasing, and storing as much of the supplies 

and equipment as possible and practical to meet the needs of children and adults with and 

without disabilities who have access and functional needs

• Develop provider agreements with the private sector to ensure that necessary equipment and 

supplies that have not been purchased and stored will be available during an emergency or 

disaster

• Develop agreements with area contractors to maintain equipment (e.g., generators, oxygen 

concentrators)
20

Emergency managers and shelter planners should include in the planning process people with 

expertise and experience in dealing with the logistical requirements of providing the resources 

necessary to set up and operate a general population shelter that includes children and adults with and 

without disabilities who have access or functional needs.

Operational Tool #8 Durable Medical Equipment (DME) List 

DME (for children and adults) Sample DME list

Source FEMA: Durable Medical Supply Sample List; Appendix 3

Operational Tool #9 Consumable Medical Supplies (CMS) List

CMS (for children 

and adults) 

Sample list of Consumable Medical Supplies using a planning estimate 

based on 100 person shelter population for one week

Source FEMA: Consumable Medical Supply Sample List; Appendix 4

Operational Tool #10 Communication Devices

Communication Devices 

(not inclusive) 

• Hearing aids 

• TTY/TDD Phones

• Cap Tel Phones (for captioning)

• Computer Assisted Real time Translation

• Hearing aid batteries of different sizes (including batteries for 

cochlear implants

• Synthesizers used with PCs for text-to-speech 

• Screen Readers

• Screen Magnification Programs

• Scanning Systems for Low Vision Users

Source Guidance on Planning and Responding to the Needs of People with 

Access and Functional Needs, California Emergency Management 

Agency, Office for Access and Functional Needs

www.oes.ca.gov/ 

Click on Office for Access and Functional Needs

Source BCFS; www.bcfs.net/fnssrecommendations

Operational Tool #11 Resources for Assistive Technology

Reuse of Assistive 

Technology

There is at least one Federally-funded program in every State that engages 

in the reuse of assistive technology. These programs are also connected to 

other entities in the State that reuse assistive technology so they can serve as a 

central point of contact for emergency managers and shelter planners.

Source http://www.resnaprojects.org/nattap/at/statecontacts.html

(contact information only)

Source http://www.resnaprojects.org/nattap/at/statecontacts.html#al

(contact information)
21

Operational Tool #12 Legal Authority-DME, CMS, Communication Devices

Legal Authority Federal agencies may, on the direction of the President, provide assistance 

essential to meeting immediate threats to life and property resulting from a 

major disaster including:

• Medicine, durable medical equipment, communication devices, goods, 

and other consumables

• Emergency medical care, emergency mass care emergency shelter, and 

provision of food, water, medicine, durable medical equipment 

In any emergency, the President may:

• Assist State and local governments in the distribution of medicine, food, 

and other consumable supplies, and emergency assistance

Federal authority for provision of PAS can be found in the reference below.

Source Sections 403 (a) (2) and (3) (B) and 502(a) (7) of the Robert T. Stafford 

Disaster Relief and Emergency Assistance Act, 42 U.S.C. §§ 5121-5206, as 

amended. Federal Disaster Assistance, 44 C.F.R. pt. 206.

http://www.fema.gov/about/stafact.shtm 

Many children and adults with and without disabilities who have access and functional needs depend 

on battery-powered wheelchairs and scooters for mobility. The batteries in these mobility aids must 

be recharged frequently or they will stop functioning. Without these mobility aids, individuals will 

lose their ability to move about, they may be unable to participate in some services offered by the 

shelter, and they may need to depend more heavily on assistance from caregivers.

4.1.8. Locating Services

State plans should include arrangements for services that are necessary to provide sufficiency of 

care in order to maintain level of function for children and adults with and without disabilities who 

have access and functional needs in a general population shelter. Emergency managers and shelter 

planners should arrange for services ahead of time through the use of provider agreements. The 

following are examples of some types of services that should be available in a general population 

shelter:

• Power Generation

◦ Redundant source of power even in the event of a long-term power outage. Some facilities 

may have no source of emergency power generation, while others may have only a 

limited source. Emergency managers and shelter planners should take whatever steps are 

necessary to see that there is a plan for providing an alternate source of power in the event 

of an outage and mechanical service contracts/services for emergency repairs.

• Medical Providers

◦ Physicians, Registered Nurses, Licensed Vocational Nurse, EMT’s and Paramedics

◦ Psychiatrists and Dental providers

◦ Emergency veterinary service provider

◦ Access to dialysis treatments (this includes providing access to transportation to and from 

the dialysis facility and a meal(s) if a resident is not at the shelter during meal time(s))

• Communications providers

◦ Interpreters (Spanish, sign language, etc.)

◦ Television with captioning

◦ Information technology/computer services

◦ TTY - TDD 
22

◦ Computer Assisted Real time Translation (CART)

◦ Note taking

• Food service providers

◦ Special diets

◦ Caterer

• Transportation providers

◦ Para transit services

◦ Public transportation

• Shelter Maintenance providers

◦ Service for accessible portable toilets, hand washing units, showers, etc.

◦ Disposal of bio-hazard materials, such as needles in sharps containers

• DME providers

◦ Oxygen providers

• CMS providers

Operational Tool #13 Locating Services

Support 

Services

Staff and resources to:

• Replace prescribed medications

• Obtain DME and CMS

• Assist persons in maintaining their usual level of independence (personal 

assistance with activities of daily living, older adult non-acute medical and 

chronic conditions, etc.)

• Provide support to persons with intellectual, cognitive, and mental health 

conditions

• Provide interpreters and/or other communication support to assist persons who 

require communication assistance deaf or hard of hearing and blind or low 

vision, speech disabilities, language/cultural differences

• Provide assistance to individuals who have conditions that affect mobility

• Provide assistance to children and adults with chronic but stable respiratory 

conditions (heart disease, asthma, emphysema, allergies, etc.)

• Provide assistance to children and adults with temporary limitations (postsurgery, injuries, pregnancy, etc.)

• Provide assistance to children and adults who require dialysis

Source Guidance on Planning and Responding to the Needs of People with Access and 

Functional Needs, California Emergency Management Agency, Office for Access and 

Functional Needs

www.oes.ca.gov/ 

Note: Click on Office for Access and Functional Needs

Source BCFS; www.bcfs.net/fnssrecommendations
23

Operational Tool #14 Documenting Service Providers

Service Provider 

Contact Information

Form used to document names, vendor number, addresses and telephone 

numbers of service providers including:

Communications Providers

• Interpreters (Spanish, sign language, etc.)

• Television with captioning

• Information Technology/Computer Services 

• TTY-TDD

• Computer Assisted Real time Translation (CART)

• Note taking

Medical Staffing Services 

• On-site nursing services

• Emergency medical services

• Emergency dental services

• Pharmaceutical services

Resource Suppliers 

• O2 

• Dialysis

• Constant power source

• Blood sugar monitoring

Food Services 

• Special diets

• Caterer

Personal Assistance Services

Transportation Services

• Para transit Services

• Public Transportation

Service Animals

• Emergency veterinary services

Shelter Maintenance Services

• Servicing of accessible portable toilets, hand washing units, etc.

• Disposal of bio-hazard materials

FNSS equipment

• Durable Medical Equipment

Source BCFS; www.bcfs.net/fnssrecommendations; FORM: Contact Information 

for Shelter Services Providers; Appendix 2

4.1.9. Staffing the Shelter

Emergency managers and shelter planners should integrate people with expertise regarding access and 

functional support needs into the staffing plan. Agencies in the stakeholder group are often a good 

resource for providing shelter staff with appropriate experience (reference section on Stakeholder 

Coordination). 

Operational Tool #15 Staffing the Shelter

Personal Assistance 

Services 

Guidance for providing personal assistance service in general population 

shelters that include children and adults with access or functional needs

Source BCFS; www.bcfs.net/fnssrecommendations in conjunction with FEMA; 

www.fema.gov; Guidance on Providing Personal Assistance Services; 

Appendix 5
24

4.1.10. Assessment Teams 

Prior to a disaster or emergency, there should be a plan for the activation of a shelter assessment team 

to assess the needs of children and adults who have access or functional needs. An entity may want 

to develop a process to credential these teams. One example of a team is the California Functional 

Assessment Service Team (FAST) described below. The FAST training is a DHS-approved course. 

Operational Tool #16 Assessment Teams

Functional 

Assessment 

Service Team 

(FAST)

The FAST responds to the needs of people in a shelter who have access or 

functional needs. The purpose of the FAST program is to conduct assessments 

of people with these needs as they arrive at the general population shelters. The 

assessment evaluates the functional needs a person has and determines resources 

necessary to support these needs in the general population shelter.

The FAST may be deployed as shelters are opened and remain in service until 

they are no longer needed. They can also transfer to another shelter as needed, 

or request to deploy to shelters as jurisdictions become aware of their existence 

during major events. 

FAST consists of trained government employees and personnel from communitybased organizations and non-governmental organizations ready to respond and 

deploy to disaster areas to work in shelters. The FAST members should have 

extensive knowledge of the populations they serve, their needs and available 

services and resources including housing, benefit programs and disaster aid 

programs. They assist in meeting essential FNSS so people can maintain their 

usual level of independence during disasters and emergencies. FAST frees 

up other emergency resources to focus on emergency incidents rather than on 

mitigating complications. 

FAST planning includes:

• Training teams

• Establishing a Memorandum of Understanding with individuals or 

organizations that will participate in the FAST 

• Maintaining contacts at the State, tribal, regional, and local level

Source Guidance on Planning and Responding to the Needs of People with Access and 

Functional Needs, California Emergency Management Agency, Office for Access 

and Functional Needs

www.oes.ca.gov/ 

Note: Click on Office for Access and Functional Needs

DHS approved FAST course (CA-049-REST)

http://www.dss.cahwnet.gov/dis/PG1909.htm

 

Homeland Security Grant Program and Emergency Management Program Grant 

funds can be used to implement this program (California Department of Social 

Services).
25

4.1.11. Shelter Layout

Cots and other furniture items are placed in such a way that routes are accessible to people who use 

wheelchairs, crutches, or walkers. Protruding objects in ANY area where people walk throughout 

the shelter should be eliminated. Accessible routes should connect the sleeping quarters to the food 

distribution and dining quarters, bathrooms, and activity areas (reference Chapter 7 Addendum 2: 

The ADA and Emergency Shelters: Access for All in Emergencies and Disasters). 

Operational Tool #17 Shelter Layout

Estimating Shelter 

Capacity

• 20 square feet per person should be available for short-term 

or evacuation shelters and up to 40 square feet per person for 

sheltering longer than 72 hours

• People who use wheelchairs, lift equipment, a service animal, and 

personal assistance services can require up to 100 square feet

Source Sheltering People with Disabilities, Draft Space and Layout 

Considerations Universal Access Committee, Feb, 2007 

www.ct.gov/demhs/lib/demhs/space__layout_considerations.pdf

4.1.12. Shelter Intake 

Individuals are not required to provide information about their disability or access or functional 

needs, but the opportunity to provide that information must be given. Emergency managers and 

shelter planners should include in their plans specific strategies for complying with the legal mandate 

that people with disabilities must be able to access the same programs and services as the general 

population. An individual request for an accommodation, based on disability, should be provided 

even if not requested during the initial intake.
26
27

4.2. Key Considerations 

In Planning For Shelter 

Operations

Segregating children and adults with and without disabilities who have access or functional needs and 

those with whom they are associated from general population shelters to “special needs” shelters is 

ineffective in achieving equitable program access and violates Federal law. People with disabilities 

are entitled by law to equal opportunity to participate in programs, services, and activities in the most 

integrated setting appropriate to the needs of the individual. Additionally, children and adults with 

and without disabilities who have access and functional needs should not be sheltered separately from 

their families, friends, and/or caregivers because services they require are not available to them in 

general population shelters. 
28

4.2.1. Dietary

Plans should include provisions to ensure meals and snacks are provided to all shelter residents, 

including children and adults with specific dietary needs and restrictions (e.g., people with diabetes 

or severe allergies to common food ingredients and baby formulas). Plans should also include a 

process for responding quickly to unanticipated, but legitimate, dietary needs and restrictions that are 

identified when a resident is admitted to the shelter. It is critical that information about any special 

dietary needs or restrictions be obtained, documented, and communicated to the entity responsible for 

meal and snack preparation immediately. Food preparation may need to be adjusted (e.g., food may 

need to be pureed) to meet resident needs. 

Operational Tool #18 Dietary-Agreement

Resources 

for Meeting 

Dietary Needs

Develop a memorandum of agreement or contract with a local organization(s) 

that has demonstrated capacity to provide meals and snacks to large populations 

including:

• Hospitals

• Local restaurants or cafeterias

• Schools

• Non-profits with a feeding crew

Source BCFS; www.bcfs.net/fnssrecommendations

Source Multi Agency Feeding Plan; http://www.nvoad.org/index.php/rl/doc_download/8-

multi-agency-feeding-plan.html

In order to meet all the needs of all people in the shelter, menus that are low sodium, low fat and low 

sugar should be developed for general population shelters and should include specific instructions 

regarding what to purchase in order to prepare each meal. Organizations contracting to prepare meals 

and snacks should also anticipate and be prepared to provide meals for persons with other dietary 

restrictions (e.g., vegetarian, gluten-free meals, kosher meals, meals for people who are allergic to 

peanut oil and by-products). 

Operational Tool #19 Dietary-Menu

One Day Menu for General 

Population Shelter

Menu for general population shelters, including modifications for 

persons who are diabetic, require reduced sodium, pureed diets and 

infants and children

Source BCFS; www.bcfs.net/fnssrecommendations; One Day Menu for 

General Population Shelters Providing Functional Needs Support 

Services; Appendix 6 

4.2.2. Service Animals 

Under the ADA, a service animal is any animal that is individually trained to provide assistance to a 

person with a disability. Most people are familiar with dogs that guide people who are blind or have 

low vision, but there are many other functions that service animals perform for people with a variety 

of disabilities. Examples include alerting people who are deaf or hard of hearing to sounds; pulling 

wheelchairs; carrying or retrieving items for people with mobility disabilities or limited use of arms 

or hands; assisting people with disabilities to maintain their balance or stability; alerting people to, 

and protecting them during, medical events such as seizures; and working or performing tasks for 
29

individuals with psychiatric, neurologic, or intellectual disabilities, such as waking up a person with 

depression, assisting a person with Alzheimer’s in way-finding, retrieving misplaced objects for 

persons with traumatic brain injury, protecting a child with autism from self injury, or orienting an 

individual with schizophrenia to their environment. 

Many emergency shelters do not allow residents or volunteers to bring their pets or other animals 

inside, but shelters must make exceptions to “no pets” or “no animals” policies to allow people with 

disabilities to be accompanied by their service animals. Service animals are not pets and are therefore 

not subject to restrictions applied to pets or other animals.

While dogs are the most common type of service animal, other types of animals can also be service 

animals. There are also no limitations on the size or breed of dogs that can be used as service animals. 

Many service animals are easily identified because they wear special harnesses, capes, vests, scarves, 

or patches. Others can be identified because they accompany individuals with visible disabilities and 

the functions they perform can also be readily observed. When none of these identifiers are present, 

shelter staff may ask only two questions to determine if an animal is a service animal: 

(1) “Is this a service animal required because of a disability?” 

(2) “What work or tasks has the animal been trained to perform?” 

If the answers to these questions reveal that the animal has been trained to work or perform tasks 

or services for a person with a disability, it qualifies as a service animal and must be allowed to 

accompany its owner anywhere other members of the public are allowed to go, including bathrooms, 

areas where food is served, and almost all areas where medical care is provided. Questions about the 

nature or severity of a person’s disability or ability to function may not be asked. The ADA also does 

not permit shelter staff to question a person’s need for a service animal or exclude a service animal 

on the grounds that shelter staff or volunteers can provide the assistance normally provided by the 

service animal. Under the ADA, shelter staff may not require a license, certification, ID tag, medical 

certificate, or any other type of documentation for a service animal.

Operational Tool #20 Service Animals Definition

ADA Best Practices Tool 

Kit, Chapter 7 Addendum 1

The ADA and Emergency Shelters: Access for All in Emergencies 

and Disasters, pages 6-7

Source http://www.ada.gov/pcatoolkit/chap7shelterprog.pdf 

In addition to the requirements set out in the ADA, the shelter may be covered by the Fair Housing 

Act (FHA). The FHA affords individuals with disabilities the right to use service animals in housing. 

Plans should direct that, prior to an emergency or disaster, the following issues be addressed:

• Areas where animals can be housed, exercised, and toileted should be identified and 

communicated in alternative accessible formats in each general population shelter 

• A reliable source for food and supplies (water bowls, leashes, collars) for the animals should 

be located and agreements be made to ensure that these items are available 
30

4.2.3. Communication

Effective communication is essential during an emergency or disaster. Children and adults with 

and without disabilities who have access or functional needs should be given the same information 

provided to the general population using methods that are understandable and timely. The ADA 

states that a public entity shall take appropriate steps to ensure that communication with applicants, 

participants, and members of the public with disabilities are as effective as communication with 

others. Effective communication requirements also apply to private and non-profit entities providing 

sheltering services. 

Plans should direct that, prior to an emergency or disaster, the auxiliary aids and services necessary to 

meet the communication needs of all persons in the shelter are identified and immediately available. 

Where possible, emergency managers and shelter planners should already have contracts and/or 

memorandums of agreement in place with the vendors who can provide these items and services. 

Operational Tool #21 Communication-Strategies

General Assign volunteers ahead of time to provide one-on-one assistance 

to residents who need help in providing and receiving effective 

communication throughout the sheltering process (e.g., completing forms) 

Blind and Low Vision Provide Braille, large and high contrast print, audio recording, readers

Deaf or Hard of 

Hearing, Speech 

Disability

Provide qualified sign language or oral interpreter; augmentative 

communication device; post message in central location; have notepads, 

pens and pencils

Intellectual Disability Present information slowly, use simple language and speak in short 

sentences

Source FEMA: Accommodating Individuals with Disabilities in the Provision of 

Disaster Mass Care, Housing and Human Services

http://www.fema.gov/oer/reference/index.shtm

Source Chapter 7 Addendum 2: The ADA and Emergency Shelters: Access for 

All in Emergencies and Disasters

http://www.ada.gov/pcatoolkit/chap7shelterprog.pdf

Operational Tool #22 Communication-Devices

Communication 

Devices

All communication devices must be accessible to people with access or 

functional needs 

Telephone Access to teletypewriter (TTY or TDD or CapTel)

Television Accessible captioning

Computers Equipment and programs that make computers accessible to people who 

are deaf, blind, those who have intellectual or mobility disabilities 

Source BCFS; www.bcfs.net/fnssrecommendations

In each case, the type of auxiliary aid or service required depends on several factors, including 

the length, complexity and importance of the communication and the person’s language skills 

and history. For example, it is no help to have an American Sign Language (ASL) interpreter 

available to communicate with deaf residents if the resident uses Signed English or other forms of 

communication. 
31

4.2.4. Bathing and Toileting Needs

Whenever bathing and toileting facilities are available in a general population shelter they must 

include accessible bathing and toileting facilities for children and adults. If a shelter does not have 

accessible facilities or if there are very limited accessible facilities available, plans should include 

ways this limitation will be addressed. This can include agreements with private contractors to 

provide these facilities.

Operational Tool #23 Bathing and Toileting Ratios – Red Cross

Portable Accessible Showers, 

Toilets, and Sinks

Red Cross ratio: The American Red Cross recommends that, on 

average, there should be one toilet for every 20 persons in the 

shelter. Count only those facilities that will be accessible to shelter 

residents and shelter staff.

Source American Red Cross Mass Care Standards and Indicators,

Version 011-072209

Many emergency managers and shelter planners look for specific ratios regarding the number of toilet 

rooms, showers, and baths to provide at an emergency shelter. In the context of the ADA Standards, 

the obligation will depend on what type of toilet facility is provided (e.g., a single-user toilet room, a 

toilet room with stalls).

Generally, each toilet room with stalls must have at least one fully accessible, standards-compliant 

water closet/stall (see 28 C.F.R. pt. 36, App. A, ADA Standards for Accessible Design §§ 4.1.2(6), 

4.16, 4.17, 4.18, 4.19, 4.22, Figs. 29, 30, 31, and 32). This includes appropriate side and rear 

grab bars, sufficient clear floor space, the toilet seat must be between 17-19 inches from the 

finished floor, and the centerline of the toilet must be 18 inches from the side wall, among several 

other requirements. For further explanation and a tool to determine adequacy to meet the ADA’s 

requirements, see ADA Best Practices Toolkit, Chapter 7 Addendum 3: ADA Checklist for Emergency 

Shelters: www.ada.gov/pcatoolkit/chap7shelterchk.htm. 

If there are six or more water closets/stalls in a toilet room, then one of the stalls, in addition to the 

accessible stall, must be an ambulatory stall with parallel grab bars and an outward swinging door 

(see 28 C.F.R. pt. 36, App. A, ADA Standards for Accessible Design §§ 4.22.4, 4.26, and Fig. 30(d)). 

When portable toilet units are clustered together at emergency shelters, at least 5% of each cluster 

must be accessible portable toilet units, identified by the International Symbol of Accessibility (see 28 

C.F.R. pt. 36, App. A, ADA Standards for Accessible Design § 4.1.2(6)).

Standards also exist for the provision of baths and showers when provided. None of these 

requirements prohibit, and emergency managers are encouraged to include, more accessible facilities 

than required or mandated by Federal law, so long as they are otherwise standards-compliant.
32

4.2.5. Quiet Area

Plans should include a strategy for providing a quiet area within each general population shelter. The 

stress that is created during and after an emergency or disaster is increased as a result of the noise and 

crowded conditions of a shelter. Without access to a quiet room or space, some people (e.g., elderly 

persons, people with psychiatric disabilities and parents with very young children, children and adults 

with autism) will be unable to function in a shelter environment (see Chapter 7 Addendum 2: The 

ADA and Emergency Shelters: Access for All in Emergencies and Disasters: http://www.ada.gov/

pcatoolkit/chap7shelterprog.pdf ).

4.2.6. Mental Health Services

Because there are differences in State and local laws, rules and regulations related to the provision of 

mental health services, it is important that, early in the planning process, emergency managers and 

shelter planners seek guidance from people with disabilities and others with access and functional 

needs and appropriate State and local authorities regarding these matters.

Emergency managers and shelter planners should include people with expertise regarding children 

and adults with and without disabilities who have access and functional needs in the mental health 

staffing plan. Agencies in the stakeholder group are often a good resource for shelter staff with 

appropriate experience (reference section on Stakeholder Coordination). 

Ideally, plans should include a directive to pre-identify a licensed mental health professional(s) who 

will be present in a general population shelter at all times. If that is not possible due to a lack of 

resources, then plans should provide that a licensed mental health professional is on call to a shelter at 

all times. Where possible, a psychiatrist should also be on call at all times. 

Operational Tool #24 Mental Health Services

Sources for 

Mental Health 

Services

Sources include colleges and universities (faculty and students), mental health 

organizations, social services agencies, and places of worship.

The New Jersey Division of Mental Health Services (DMHS) within the New 

Jersey Department of Human Services (NJDHS) has over 120 contracted 

community mental health provider agencies.

Substance Abuse and Mental Health Services Administration (SAMHSA) has 

the contract to provide mental health counseling in emergency situations.

Source BCFS; www.bcfs.net/fnssrecommendations

Source http://www.samhsa.gov/dtac/

4.2.7. Medical and Dental Services

Because there are differences in State and local laws, rules, and regulations related to the provision of 

medical and dental care, it is important that, early in the planning process, emergency managers and 

shelter planners seek guidance from appropriate State and local authorities regarding these matters.
33

Children and adults with and without disabilities who have access or functional needs who require 

medical services may not be excluded from a general population shelter. Plans should direct that, 

at a minimum, medical care that can be provided in the home setting (e.g., assistance in wound 

management, bowel or bladder management, or the administration of medications or use of medical 

equipment) is available to each general population shelter.

Plans should be in place for addressing medical and dental care decisions at all times. This could 

include making contracts/agreements prior to an emergency or disaster for the personnel and 

supplies necessary to set up and staff a first aid station at each shelter site. Having these plans in 

place is intended to prevent inappropriate transfers to medical facilities. This will benefit the whole 

community by maximizing resources and limiting medical surge.

A comprehensive list of emergency medical and dental services in the area should be maintained at all 

times. 

Operational Tool #25 Medical Station

Onsite Medical Staff • Provide OTCs

• Implement methods to minimize contagion

• Make referrals for emergency medical and dental treatment

Medical Station Staff with a minimum of 1 RN and 1 paramedic at ratio of 1:100 shelter 

residents at all times

Oncall Medical Staff Maintain on call physician and psychiatrist 24/7

Source BCFS; www.bcfs.net/fnssrecommendations

Operational Tool #26 Disaster Health Response and Care

Services • Perform health assessments and referrals

• Implement infection control methods and perform illness and injury 

surveillance

• Facilitate replacement of medications, CMS and DME

Shelter Staffing Staff with 1 licensed health professional (minimum licensure is EMT) at 

ratio of 1:100 shelter residents at all times

Source American Red Cross; www.redcross.org

Plans should also include a requirement to document any medical care provided at the shelter and a 

strategy for accomplishing these efforts. 

Operational Tool #27 Medical Services-Form

Resident Health Care 

Record

Form to document a resident’s visit to the first aid station and any offpremises medical or dental care

Source BCFS; www.bcfs.net/fnssrecommendations; FORM: Resident Health Care 

Information; Appendix 7

In the event of a medical or dental emergency, plans should direct shelter staff to call 911 and refer 

residents for medical or dental care, as appropriate. 
34

4.2.8. Medication 

Because there are differences in State and local laws, rules, and regulations related to the storage, 

preparation, administration, documentation, and disposal of medications, it is important that, early in 

the planning process, emergency managers and shelter planners seek guidance from appropriate State 

and local authorities regarding these matters.

The fact that a person has or requires medications is not a basis for excluding him/her from a general 

population shelter. Plans should include procedures for obtaining, storing, dispensing, documenting, 

and disposing of medications in a general population shelter.

Plans should ensure that shelter residents have access to medications. One way to accomplish this is 

to have contracts or agreements in place with a pharmacy(s) to make medications available to shelter 

residents. This will minimize the time a resident has to go without necessary medications. 

Operational Tool #28 Medication

Filling Prescriptions When a pharmacy(s) is part of a chain of pharmacies, the pharmacist may 

be able to obtain information about a shelter resident’s medications by 

checking records kept in a centralized location away from the community 

where the emergency or disaster occurred. 

Storage As a rule, residents are responsible for safeguarding, storing, and 

administering their own medication. If that is not practical (due to need for 

refrigeration, concerns regarding drug security, or the ability of the resident 

to self-medicate), residents’ prescription medications should be kept in a 

locked container used exclusively for that purpose at the first aid station.

Disposal If medications are kept in the first aid station, staff should return all 

resident medications, including those that have been discontinued or have 

passed the expiration date, when the resident is discharged from the shelter. 

Needles or hypodermic syringes with needles attached must be disposed of 

in bio-hazard containers. 

Source BCFS; www.bcfs.net/fnssrecommendations; FORM: Medication 

Administration Record; Appendix 8

Operational Tool #29 Medication-Emergency Prescription Assistance Program (EPAP)

Program Description EPAP, a joint program of FEMA and the Department of Health and 

Human Services, provides an efficient way for pharmacies to process 

claims for prescription medications and limited DME for individuals 

who have no insurance coverage and are from an area declared as 

a disaster by the President. Claims for individuals with private 

insurance, employer-sponsored coverage, public insurance, or other 

third party coverage are not eligible for payment under the EPAP.

Services Provided Provides a 30-day supply of essential pharmaceutical and DME lost as 

a direct result of the disaster or as a secondary result of loss or damage 

caused while in transit from the emergency site to the designated 

shelter facility.

Participating Pharmacies Any enrolled pharmacy in the U.S. and its territories

Source http://www.hhs.gov/aspr/opeo/epap/index.html
35

Sections 403 (a) (2) and (3) (B) and 502(a) (7) of the Robert T. Stafford Disaster Relief and 

Emergency Assistance Act, 42 U.S.C. §§ 5121-5206, as amended. Federal Disaster Assistance, 44 

C.F.R. pt. 206.

http://www.fema.gov/about/stafact.shtm

4.2.9. Transportation Services

Children and adults with and without disabilities who have access or functional needs may require 

transportation services while in shelters and for re-entry into the community. Emergency managers 

and shelter planners should see that plans include strategies to ensure that accessible vehicles, 

ambulances, and drivers are available to the shelter. 

Accessible vehicles should be able to transport wheelchairs, scooters, or other mobility aids, as well 

as equipment and supplies (e.g., portable oxygen, portable toilets, communication devices, service 

animals). Even if accessible public or private transportation is ordinarily available, there should be a 

contingency plan for transporting people if this transportation is disrupted. 

Contingency plans for hazards occurring during a sheltering event should include readily available 

resources for transporting people with access and functional needs, as well as their life sustaining 

equipment, to alternative shelter sites. 

Operational Tool #30 Transportation Services

Transportation Accessible 

Resources

Potential accessible resources include:

• Local school districts with lift-equipped school buses

• Community EMS services

• Vans from places of worship

• Local assisted living facility vans

• Local community and public transit vehicles

• Para transit services

• Dial-a-Ride

• Fixed route buses

• Area agencies on aging

• Regional center vendors

• Taxi systems

• Non-medical emergency services

• Adult day health care vehicles

• Airport car rental shuttle buses

• Airport shuttle buses

• Older adults center vendors

• Health care center vendors

Source Guidance on Planning and Responding to the Needs of People with 

Access and Functional Needs, California Emergency Management 

Agency, Office for Access and Functional Needs

www.oes.ca.gov/ 

Click on Office for Access and Functional Needs

Source BCFS; www.bcfs.net/fnssrecommendations
36

Plans should include: 

• An agreement or contract with transit providers in place prior to an emergency or disaster

• A pre-determined process for reimbursing transit providers for their services 

Note that transportation providers may have prearranged agreements with multiple entities that would 

result in insufficient services if an emergency affected an entire State or region. 

Operational Tool #31 Transportation Services - Form

Transportation Request Form to request resident transportation for:

• Appointments and activities while living at the shelter

• Returning home or to temporary house at discharge

Source BCFS; www.bcfs.net/fnssrecommendations; FORM: Transportation 

Request Information; Appendix 9
37

4.3. Key Considerations In 

Planning For Transition/

Recovery

4.3.1. Transitioning Back to the Community

In order for children and adults who have access or functional needs to transition back to their 

community, it is important to provide them a reasonable amount of time and assistance to locate 

suitable housing when they cannot return to their former homes. In the past, shelters have sometimes 

required people needing FNSS to move to hospitals, nursing homes, or other institutions because 

they could not quickly locate suitable housing or the supportive services needed to live on their 

own. As a result, people who once lived independently in their own homes have found themselves 

institutionalized soon after an emergency or disaster occurred. 

To comply with ADA requirements and assist people in avoiding unnecessary institutionalization, 

emergency managers and shelter planners should include strategies for children and adults with 

functional support needs in their plans to have the time and assistance required to:

• Return to their homes, or 

• Locate new homes in the most integrated setting that is appropriate to their needs 

Organizations providing direct services to people with disabilities and others with access or functional 

needs should be included in all local assistance and disaster recovery efforts to:

• Promote coordination with one other 

• Maximize resources 

• Eliminate duplication 

Operational Tool #32 Transitioning Back to the Community

Gap Analysis Tool for:

• Re-entry 

• Demobilization

• Trigger point established for when to return children and adults 

• Transport plan for individuals unable to get home from 

transportation assembly points

• Trigger points established for when to demobilize transit resources

• Procedure established to check-out emergency evacuation 

resources

• Procedure established to debrief demobilizing personnel

• Procedure established to debrief children and adults

• Demobilization procedures reviewed at least annually

Source Guidance on Planning and Responding to the Needs of People with 

Access and Functional Needs, California Emergency Management 

Agency, Office for Access and Functional Needs; www.oes.ca.gov/ 

Note: Click on Office for Access and Functional Needs

Every effort should be made to move residents back to the least restrictive environment.
38

Operational Tool #33 Transitioning Back to the Community - Recovery

Possible Recovery 

Needs

• Short- and long-term housing and wrap-around housing 

(Accessible)

• Communication

• Replacement of DME and assistive technology

• Personal assistance services

• Transportation 

• Financial assistance

Source Guidance on Planning and Responding to the Needs of People with 

Access and Functional Needs, California Emergency Management 

Agency; www.oes.ca.gov/ 

Note: Click on Office for Access and Functional Needs

Operational Tool #34 Transitioning Back to the Community - Re-entry

Re-entry Planning 

Strategy

Prior to an emergency/disaster: 

• Locate and document all available accessible hotel/motel rooms in 

the community

• Develop contracts/agreements with these entities to reserve 

resources for people with access or functional needs 

• Determine a process for reimbursing businesses for these resources

Source BCFS; www.bcfs.net/fnssrecommendations

4.3.2. Closing the Shelter

 It is important to remember that shelters are temporary and every effort should be made to close the 

shelter by identifying and using the resources necessary to return residents to suitable housing that 

continues to meet their access and functional needs. The goal is to always support individuals toward 

self sufficiency. 

Operational Tool #35 Closing the Shelter

Considerations when 

Closing a Shelter

Consider:

• Impact of the emergency or disaster on the home or environment of 

a person with access or functional needs (e.g., a person’s home is not 

damaged but rest of the neighborhood is gone, power out, etc.)

• The urgency of the need to return the shelter to normal conditions

• Availability of accessible transportation resources

Source Kansas Statewide Emergency Management; http://www.srskansas.org/

Note: Click on SRS Statewide Emergency Management, click on Assisting 

Individuals with Functional Needs During Evacuation and Sheltering, scroll 

down to Functional Needs Shelter Deactivation

Recovery is typically the longest and most difficult part of an emergency or disaster for all residents 

of a community. It is further complicated when people with disabilities and others with access 

or functional needs do not have access to personal assistance services, service animals, friends, 

neighbors, neighborhood businesses and even family members. 
39

Operational Tool #36 Closing the Shelter- Discharging Residents

Considerations when 

Discharging a Resident 

Requiring FNSS

Form documenting a resident’s discharge from the facility including 

confirmation that a resident is discharged to his/her home:

• Determined by police or other emergency management personnel 

in his or her community that he/she can return

• Contacted his or her landlord or neighbor to determine whether his 

or her house is habitable 

• Confirmed that any prior in-home services are restored (e.g., 

Meals on Wheels, Mental Heath Authority, Personal Assistance 

Services)

• Confirmed access to businesses necessary to return home (e.g., 

grocery store, pharmacy

Source BCFS; www.bcfs.net/fnssrecommendations; FORM: Resident Discharge 

Information; Appendix 10

Emergency managers and shelter planners can do little to counter some of the conditions people with 

FNSS face during the recovery phase. They can, however, develop strategies so that the most critical 

services and functional needs are restored or addressed as a priority during this phase.

Operational Tool #37 Closing the Shelter- Recovery

Recovery Plan 

Considerations

• Making allowances at blockades, shelters, and other impacted 

areas for access to people providing personal assistance services, 

home health aids, visiting nurses, interpreters, support or service 

animals, and other individuals crucial to immediate functional 

needs of individuals

• Identifying the impact an interruption in utility services would 

have on children and adults with and without disabilities who have 

access and functional needs

• Planning for accessible shelter and appropriate temporary housing 

needs

• Addressing how people with disabilities and others with access or 

functional needs who are employed by businesses that are able to 

open soon after a disaster will get to work

• Involving representatives of the functional needs community in 

“after action reviews” or “hot wash reports” in order to capture the 

true impact of the disaster and to improve plans for the future

Source New Hampshire Functional Needs Guidance – Support Document to the 

State Emergency Operations Plan http://www.nh.gov/safety/divisions/

hsem/stateemergplan/index.html

Ideally, emergency managers and shelter planners should include the infrastructure needed to support 

recovery in the State plan long before an emergency or disaster occurs. 
40

5. Acronyms

ADA Americans with Disabilities Act

AED Automated External Defibrillator

ASL American Sign Language

CART Computer Assisted Real time Translations

CBO Community-Based Organization

CDC Centers for Disease Control and Prevention

CMS Consumable Medical Supplies

DME Durable Medical Equipment

DRA Disability Related Assistance

EPAP Emergency Prescription Assistance Program

FAST Functional Assessment Service Teams

FEMA Federal Emergency Management Agency

FNSS Functional Needs Support Services

ICP Incident Command Post

IMT Incident Management Team

OTC Over-the-counter Drugs

PAS Personal Assistance Services

SOP Standard Operating Procedures

TDD Telecommunications Device for the Deaf

TTY Teletypewriter

VOAD Voluntary Organizations Active in Disasters 
41

6. Glossary

Access

The ability to fully use, enjoy, and integrate into any programs, services, activities, goods, 

facilities, privileges, advantages, or accommodations provided by a public or private (for-profit or 

not-for-profit) entity, any contracted entity, or entity that provides emergency services, including 

sheltering, for individuals with disabilities as defined by the ADA Amendments Act of 2008, P.L. 

110-325, and those associated entities. Access may include modifications to programs, policies, 

procedures, architecture, equipment, services, supplies, and communication methods.

Access and Functional Needs

Those actions, services, accommodations, and programmatic, architectural, and communication 

modifications that a covered entity must undertake or provide to afford individuals with 

disabilities a full and equal opportunity to use and enjoy programs, services, activities, goods, 

facilities, privileges, advantages, and accommodations in the most integrated setting, in light 

of the exigent circumstances of the emergency and the legal obligation to undertake advance 

planning and prepare to meet the disability-related needs of individuals who have disabilities as 

defined by the ADA Amendments Act of 2008, P.L. 110-325, and those associated with them. 

Access and functional needs may include modifications to programs, policies, procedures, 

architecture, equipment, services, supplies, and communication methods. Examples of “access 

and functional needs” services may include a reasonable modification of a policy, practice, or 

procedure or the provision of auxiliary aids and services to achieve effective communication, 

such as: (1) an exception for service animals in an emergency shelter where there is a no pets 

policy; (2) the provision of way-finding assistance to someone who is blind to orient to new 

surroundings; (3) the provision of transferring and toileting assistance to an individual with a 

mobility disability; and (4) the provision of an interpreter to someone who is deaf and seeks to fill 

out paperwork for public benefits.

Action Plan 

A plan developed by a case manager and resident(s) to assist and support that individual or family 

in obtaining transitional or permanent living arrangements.

Cap Tel

A communication system that provides written captions of everything a caller says on a built-in 

display. 

Consumable Medical Supplies (CMS)

Medical supplies (medications, diapers, bandages, etc.) that are ingested, injected, or applied and/

or are one time use only. 
42

Disability

The term “disability” has the same meaning as that used in the ADA Amendments Act of 2008, 

P.L. 110-325, as incorporated into the ADA. See http://www.ada.gov/pubs/ada.htm for the 

definition and specific changes to the text of the ADA. State laws and local ordinances may also 

include individuals outside the Federal definition.

Durable Medical Equipment (DME)

Medical equipment (e.g., walkers, canes, wheelchairs, etc.) used by persons with a disability to 

maintain their usual level of independence. 

First Aid Station

Dedicated section in the shelter where residents receive first aid and/or referrals for emergency 

medical, mental, or dental health care.

Functional Needs Support Services (FNSS)

Services that enable children and adults to maintain their usual level of independence in a 

general population shelter. FNSS includes reasonable modifications to policies, practices, and 

procedures, durable medical equipment (DME), consumable medical supplies (CMS), personal 

assistance services (PAS), and other goods and services as needed. Children and adults requiring 

FNSS may have physical, sensory, mental health, and cognitive and/or intellectual disabilities 

affecting their ability to function independently without assistance. Others who may benefit from 

FNSS include women in late stages of pregnancy, elders, and those needing bariatric equipment. 

Least restrictive environment

The opportunity for adults and children with disabilities and others with access or functional 

needs to be with non-disabled peers to the greatest extent possible. These individuals should 

have access to the general shelter activities or any other programs and services that non-disabled 

persons can access. Generally, the less opportunity a person with a disability has to interact with 

non-disabled persons (peers), the more the shelter (placement) is considered to be restricted.

Medical Staff

Licensed or certified physicians, registered nurses, licensed vocational nurses, emergency medical 

technicians, and paramedics. 

Mental Health Professional 

A person who is licensed to provide counseling. 

Personal Assistance Services

Services that assist children and adults with activities of daily living (e.g., bathing, toileting, 

eating, etc.).

Service Animal

Any animal that is individually trained to provide assistance to a person with a disability.
43

Shelter

A temporary facility which provides housing and basic services until persons can return home or 

obtain temporary or permanent house elsewhere.

Staff

People who are assigned a position in the shelter and who may or may not be paid for their 

services.

Universal cot

A Universal/Accessible cot that meets the following recommended criteria: 

• Height – 18”-19” without [below] the mattresses

• Width – minimum 27” 

• Weight capacity – 350+ pounds 

• Flexible head position

• Rails, if any, must be positioned or moveable in such a way as to allow for wheelchair 

access (No IV pole) 

Volunteers

Persons who are assigned staff positions in a shelter and meet the qualifications of that position 

but are not paid for their services. 
44

7. Operational Tools *

Operational Tool #1 Planning Guidance

Operational Tool #2 Stakeholder Coordination

Operational Tool #3 Planning Shelter Capacity

Operational Tool #4 Locating the Shelter

Operational Tool #5 Evaluating the Shelter - Site Selection Tool

Operational Tool #6 Florida Shelter Selection Checklist

Operational Tool #7 San Jose California Shelter Assessment Checklist 

Operational Tool #8 Durable Medical Equipment (DME) List

Operational Tool #9 Consumable Medical Supplies (CMS) List

Operational Tool #10 Communication Devices

Operational Tool #11 Resources for Assistive Technology

Operational Tool #12 Legal Authority - DME, CMS, Communication Devices 

Operational Tool #13 Locating Services

Operational Tool #14 Documenting Service Providers

Operational Tool #15 Staffing the Shelter

Operational Tool #16 Assessment Teams

Operational Tool #17 Shelter Layout

Operational Tool #18 Dietary - Agreement

Operational Tool #19 Dietary - Menu

Operational Tool #20 Service Animals - Definition

Operational Tool #21 Communication - Strategies

Operational Tool #22 Communication - Devices

Operational Tool #23 Bathing and Toileting Ratios - Red Cross

Operational Tool #24 Mental Health Services

Operational Tool #25 Medical Station

Operational Tool #26 First Aid Station 

Operational Tool #27 Medical Services - Form

Operational Tool #28 Medication

Operational Tool #29 Medication - Emergency Prescription Assistance Program (EPAP)

Operational Tool #30 Transportation Services

Operational Tool #31 Transportation Services - Form

Operational Tool #32 Transitioning Back to the Community 

Operational Tool #33 Transitioning Back to the Community - Recovery

Operational Tool #34 Transitioning Back to the Community - Re-entry

Operational Tool #35 Closing the Shelter

Operational Tool #36 Closing the Shelter - Discharging Residents

Operational Tool #37 Closing the Shelter - Recovery

* Operational Tools – The operational tools in this document are excerpts and examples taken from 

various agency and jurisdictional documents throughout the United States. While they are not meant 

to dictate a State’s policies or procedures, they do present ideas and practices that can be adapted to fit 

each State’s specific needs.
45

8. Appendices

Page Appendix

47 Appendix 1 ADA Checklist for Emergency Shelters

115 Appendix 2 FORM: Contact Information for Shelter Services Providers

117 Appendix 3 Durable Medical Supply Sample List

118 Appendix 4 Consumable Medical Supply Sample List

125 Appendix 5 Guidance on Providing Personal Assistance Services 

155 Appendix 6 One Day Menu for General Population Shelters Providing Functional 

Needs Support Services

156 Appendix 7 FORM: Resident Health Care Information

158 Appendix 8 FORM: Medication Administration Record

160 Appendix 9 FORM: Transportation Request Information

162 Appendix 10 FORM: Resident Discharge Information
46
47

Appendix 1

ADA Checklist for Emergency Shelters

For the 508 compliant version of the ADA Checklist for Emergency Shelters 

go to http://www.ada.gov/pcatoolkit/chap7shelterchk.htm
48
ADA Checklist for Emergency Shelters

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ADA Checklist for Emergency Shelters ............................... 1

A. Evaluating the Physical 

 Accessibility of Emergency Shelters .................................... 1

B. Conducting Accessibility Surveys ........................................ 2C. Getting Started ...................................................................... 2D. Tools Needed .......................................................................... 3E. Taking Measurements ........................................................... 3

1. Sloped Surfaces .............................................................. 32. Using the Tape Measure .................................................. 43. Measuring Door Openings .............................................. 5

F. Taking Photographs ................................................................ 5G. Completing the Survey and Checklist .................................. 5H. After Completing the Survey and Checklist ........................ 6

Step One: Accessible Shelter Quick-Check Survey ............ 7Selecting Sites to Survey for Accessibility ..................................... 7

A. Accessible Entrance ............................................................. 7B. Accessible Routes To All Service/Activity Areas ................. 8 

C. Accessibility within Toilet Rooms ......................................... 10

Step Two: Ada Checklist For Emergency Shelters ............... 11Getting to the Emergency Shelter .................................................. 11

A. Passenger Drop-Off Areas .................................................... 11B. Parking ................................................................................... 14

1. Typical Issues .................................................................. 14

2. Parking Spaces Checklist ............................................... 153. Temporary Solutions for  Emergency Sheltering - Parking ................................... 18

C. Sidewalks and Walkways ...................................................... 19

1. Typical Issues for Individuals  Who Use Wheelchairs, Scooters,  or other Mobility Devices ............................................... 19

Accessible Ramp Features ......................................... 21Temporary Solutions For Emergency Sheltering - Ramps ..................................................... 22

2. Typical Issues for Individuals Who  Are Blind or Have Low Vision ........................................24

Temporary Solutions For Emergency Sheltering - Protruding Object Hazards ................... 26

D. Entering the Emergency Shelter .......................................... 27

 Building Entrance ............................................................... 27

E. Hallways and Corridors ........................................................ 30

1. Typical Issues for Individuals Who Use  Wheelchairs, Scooters, or Other Mobility Devices ....... 302. Typical Issues for People Who are Blind  or Have Low Vision ........................................................ 37

F. Check-In Areas ........................................................................ 39

Living at the Emergency Shelter ........................................... 40

G. Sleeping Areas ....................................................................... 40H. Restrooms and Showers ....................................................... 42

 Toilet Stalls ......................................................................... 46

I. Public Telephones ................................................................. 50J. Drinking Fountains ............................................................... 52K. Eating Areas .......................................................................... 54

Other Issues ............................................................................ 56

L. Availability of Electrical Power ............................................ 56M. Single-User or “Family” Toilet Room ................................. 57N. Health Units/Medical Care Areas ........................................ 62O. Accessible Portable Toilets ................................................... 63
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ADA Emergency Shelter Checklist

3
2. Using the Tape Measure

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Using a tape measure to measure the width of a 

parking space

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and tape measure

4

ADA Emergency Shelter Checklist
3. Measuring Door Openings

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Measuring the clear opening from 

the face of the doorstop on the 

frame to the face of the open door

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ADA Emergency Shelter Checklist

5
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6

ADA Emergency Shelter Checklist
Step One: Accessible Shelter Quick-Check Survey

Yes _____ No _____ 

Yes _____ No _____ 

A. Accessible Entrance +DYLQJ D ZD\ WR JHW LQWR WKH HPHUJHQF\ VKHOWHU RQ D VXUIDFH WK

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A1. Is there a sidewalk connecting the parking area and any drop off area to 

the walkway leading to the building? [ADA Standards § 4.1.3(1)] 

A2. Is there a route without steps from this sidewalk to the main entrance?

If No, are there two or fewer steps? 

Yes _____ No ____ Number of Steps: _____

If No, is there another entrance without steps that is connected by a sidewalk to theparking or drop off area? 

Yes _____ No _____Location: ______________________________

 _________________________________________________________

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7

Accessible Quick-Check Survey

Notes/Comments
Yes _____ No _____ 

Yes _____ No _____ 

Yes _____ No _____ 

Notes/Comments B. Accessible Routes To All Service/Activity Areas

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B1. Sleeping Area (Location: ______________________________________)

B1-a. Is there a route without steps from the accessible entrance to this 

location?

If No, are there two or fewer steps? Yes ___ No ___Number of Steps: _______

If No, is there a ramp, lift, or elevator? Yes ___ No ___Type of device: _______

B1-b. If an elevator or lift provides the only accessible route, is there 

a source of backup power to operate the device for an extended period?

B2. Eating Area (Location: ______________________________________)

B2-a. Is there a route without steps from the accessible entrance to this 

location?

If No, are there two or less steps? Yes ___ No ____ Number of Steps: _____If No, is there a ramp, lift, or elevator? Yes ___ No ____ Type of device: _______

8

Accessible Quick-Check Survey
B2-b. If an elevator or lift provides the only accessible route, is there a 

source of back up power to operate the device for an extended period?

B3. Supply Distribution Area (Location: _____________________________)

B3-a. Is there a route without steps from the accessible entrance to this 

location?

If No, are there two or fewer steps? 

Yes ___ No ___ Number of Steps: ______

If No, is there a ramp, lift, or elevator? 

Yes ___ No ___ 

Type of device: ______

B3-b. If an elevator or lift provides the only accessible route, is there 

a source of backup power to operate the device for an extended period?

B4. Toilet Rooms (Location: ________________________________________)

B4-a. Is there a route without steps from the accessible entrance to this 

location?

If No, are there two or fewer steps? 

Yes ___ No ____ Number of Steps: ______

If No, is there a ramp, lift, or elevator? 

Yes ____ No ____ 

Type of device: ______

B4-b. If an elevator or lift provides the only accessible route, is there 

a source of backup power to operate the device for an extended period?

Yes _____ No _____ 

Notes/Comments Yes _____ No _____ 

Yes _____ No _____ Yes _____ No _____ Yes _____ No _____ 

9

Accessible Quick-Check Survey
C. Accessibility Within Toilet Rooms

C1-a. Is there an area within the toilet room where a person who 

uses a wheelchair or mobility device can turn around - either a minimum 60-inch diameter circle or a “T”-shaped turn area? 

[ADA Standards §§ 4.22.3; 4.2.3, Fig. 3]

C1-b. Is at least one stall at least 60 inches wide and 56 inches deep 

(wall mounted toilet) or 59 inches deep (floor mounted toilet)? [ADA Standards § 4.17.3]

Fig 3

Minimum spaces for turning

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Notes/Comments

Yes _____ No _____ Yes _____ No _____ 

10

Accessible Quick-Check Survey
STEP TWO -ADA CHECKLIST FOR EMERGENCY SHELTERS

Getting to the Emergency Shelter

A. Passenger Drop-Off Areas

Notes: 

Access aisle depth is at least 5 feet.Access aisle length is at least 20 feet.

Curb ramp connects the access aisle 

for the accessible drop- off area 

(which is at the level of the parking 

lot) to the accessible route to the 

accessible entrance of the shelter.

ADA Emergency Shelter Checklist

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11

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Accessible drop-off area with an access aisle provided 

at the same level as the vehicle.
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A1. Is a relatively level (1:50 or 2% 

maximum slope in all directions) access aisle provided adjacent and parallel to the side of the vehicle pull-up area? [ADA Standards § 4.6.6]

If No, look for another relatively levellocation that is on an accessible routeto the accessible shelter entrance thatcould be used.

A2. Is the vehicle pull-up area relatively level (1:50 or 2% maximum slope in 

all directions)? 

A3. Is the area for the access aisle at least 5-feet wide and 20-feet long? 

[ADA Standards § 4.6.6].

Note: Unlike at an accessible parking space, the surface for the access aisle of anaccessible passenger drop-off area does not have to be marked or striped.

A4. Is there vertical clearance of at least 114 inches (9 feet 6 inches) from the 

site entrance to the vehicle pull-up area, the access aisle, and along the vehicle route to the exit? [ADA Standards § 4.6.5]

Yes _____ No _____

Yes _____ No _____Yes _____ No _____

Accessible drop-off area with an access 

aisle provided as part of the sidewalk.

Yes _____ No _____

Notes/Comments

12

ADA Emergency Shelter Checklist
A5. Is a curb ramp provided between the vehicle pull up area and the access 

aisle (see above) or the access aisle and the accessible route to the accessible entrance? [ADA Standards § 4.6.6]

If No, is there another area with a curb ramp and on an accessible route that couldserve as the drop-off area? If there is no curb ramp near the drop-off area, can a temporary ramp be used to connect the drop-off area access aisle to the accessibleroute to the accessible shelter entrance? 

A6. If a curb ramp is provided, is the running slope of the ramp surface (not 

counting the side flares) no more than 1:12 or 8.33%? 

 [ADA Standards § 4.7.2]A7. Is the width of the curb ramp surface at least 36 inches (not counting the 

side flares)? [ADA Standards § 4.7.3]

A8. Does an accessible route connect the curb ramp to the shelter’s

accessible entrance? [ADA Standards § 4.1.2(1)]

Yes _____ No _____Yes _____ No _____Yes _____ No _____Yes _____ No _____

Notes/Comments

ADA Emergency Shelter Checklist

13
Notes:

Accessible route.Accessible parking with van accessible parking space.Accessible entrance to shelter.

Temporary accessible parking spaces. 

B. Parking

1. Typical Issues

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An access b e entrance to an emergency s e ter 

with accessible parking and additional temporary 

accessible parking spaces

14

ADA Emergency Shelter Checklist

A i l h l
2. Parking Spaces Checklist

B1. When parking areas are provided at the shelter site, count the total 

number of parking spaces provided in each area. Is the minimum number of accessible parking spaces provided, based on the total number of available parking spaces (see table below)? [ADA Standards § 4.1.2(5)(a)]

Yes _____ No _____Yes _____ No _____

Notes/Comments

Accessible Parking Spaces Showing Minimum Width of Vehicle Space and Access Aisle

1 - 25 ..................................................................1 van-accessible space w/min. 96-inch-wide access aisle (van space)26 - 50 ................................................................1 space w/min. 60-inch-wide access aisle + 1 van space51 - 75 ................................................................2 spaces w/min. 60-inch-wide access aisle + 1 van space76 - 100 ..............................................................3 spaces w/min. 60-inch-wide access aisle + 1 van space101 - 150 .............................................................4 spaces w/min. 60-inch-wide access aisle + 1 van space

If more than 150 parking spaces are provided in a particular lot, 

T

see section 4.1.2 of the ADA Standards for the number of accessible parking spaces required.

otal Number of Parking Spaces

 in Each Parking Area

 Required Minimum Number of Accessible Spaces

B2. Does each accessible parking space have its own, or share, an adjacent 

access aisle that is least 60 inches (5 feet) wide? [ADA Standards § 4.6.3]

ADA Emergency Shelter Checklist

15
B3. Is there at least one van-accessible parking space provided with an 

access aisle that is at least 96 inches (8 feet) wide or are universal parking spaces provided that are 132 inches (11 feet) wide for vehicle 

space with a 60-inch (5-feet) wide access aisle?[ADA Standards § § 4.1.2(5), A4.6]

B4. For van-accessible spaces (particularly in a garage or parking structure), 

is there vertical clearance of at least 98 inches (8 feet - 2 inches) for the vehicle route to the parking space, the parking space, the access aisle, and along the vehicle route to the exit? [ADA Standards § 4.6.5] 

If No: Can the route be cleared by removing or raising low objects, or can each vanaccessible parking space be relocated?

B5. Are all accessible parking spaces, including the access aisle, relatively 

level (1:50 or 2%) in all directions? [ADA Standards § 4.6.3] 

If No: Look for a nearby area that is relatively level in all directions that could serve asan accessible parking space with an accessible route to the accessible entrance to theshelter.

B6. Does each accessible parking space have a sign with the symbol of 

accessibility that is visible when a vehicle is parked in the space? 

[ADA Standards § 4.6.4]

Yes _____ No _____

Yes _____ No _____Yes _____ No _____

Notes/Comments

Yes _____ No _____

16

ADA Emergency Shelter Checklist
B7. If there is a curb between the access aisle and the accessible route to the 

building, is there a curb ramp that meets the following requirements: [ADA Standards § 4.7]

Yes _____ No _____

Curb ramp showing minimum 36-inch width for ramp section and 1:12 slope on ramp section.

Yes _____ No _____

Yes _____ No _____

B7-a. Is the curb ramp surface at least 36 inches wide, excluding flared 

sides? [ADA Standards § 4.7.3]

B7-b. Is the slope (up or down the ramp) no more than 1:12?

[ADA Standards § 4.7.2] 

Note: 1:12 is one inch of vertical height for each 12 inches of length.

B8. Are the accessible parking spaces serving the shelter on the shortest 

accessible route to the accessible entrance? [ADA Standards § 4.6.2]

B9. Does each access aisle connect to an accessible route from the parking 

area to the shelter’s accessible entrance? [ADA Standards § 4.6.2]

Yes _____ No _____Yes _____ No _____

Notes/Comments

ADA Emergency Shelter Checklist

17
6XJJHVWLRQ )LQG D IDLUO\ OHYHO SDUNLQJ DUHD QHDU WKH

DFFHVVLEOH HQWUDQFH DQG PDUN WKH DUHD IRUDFFHVVLEOH SDUNLQJ VSDFHV 7KUHH UHJXODUSDUNLQJ VSDFHV ZLOO PDNH WZR DFFHVVLEOH SDUNLQJVSDFHV ZLWK D VKDUHG DFFHVV DLVOH 3URYLGH DVLJQ GHVLJQDWLQJ HDFK DFFHVVLEOH SDUNLQJ VSDFH(QVXUH WKHUH LV DQ DFFHVVLEOH URXWH IURP HDFKDFFHVV DLVOH WR WKH DFFHVVLEOH HQWUDQFH

,I WHPSRUDU\ DFFHVVLEOH VSDFHV DUH XVHG PDUN WKH WHPSRUDU\DFFHVVLEOH SDUNLQJ VSDFHV ZLWK WUDIÀF FRQHV RU RWKHU WHPSRUDU\HOHPHQWV 7UDIÀF FRQHV FDQ DOVR EH XVHG WR PDUN RII DQ DFFHVVDLVOH LI GHVLJQDWHG DFFHVVLEOH SDUNLQJ VSDFHV ODFN DQ DFFHVVDLVOH RU LI WKH DFFHVV DLVOH LV WRR QDUURZ $W OHDVW RQH DFFHVVLEOHSDUNLQJ VSDFH VKRXOG EH D YDQDFFHVVLEOH SDUNLQJ VSDFH ZLWK DQDFFHVV DLVOH WKDW LV DW OHDVW  LQFKHV ZLGH

Three standard parking spaces are converted into an accessible 

parking space with an access aisle. Cones mark the access aisle 

and a temporary curb ramp with edge protection connects to an 

accessible route to the shelter.

3. Temporary Solutions for Emergency Sheltering - Parking

3UREOHP 3DUNLQJ DW WKH VKHOWHU IDFLOLW\ HLWKHU KDV QR DFFHVVLEOH

SDUNLQJ QRW HQRXJK DFFHVVLEOH SDUNLQJ RU DFFHVVLEOHSDUNLQJ VSDFHV DUH QRW RQ OHYHO JURXQG

18

ADA Emergency Shelter Checklist
Notes:

 Accessible route

Accessible drop-off areaAccessible parking with van-accessible parking spaceAccessible entrance to shelter

C. Sidewalks and Walkways

1. Typical Issues for Individuals Who Use Wheelchairs, Scooters, or other Mobility Devices

$Q DFFHVVLEOH URXWH FRQQHFWV DFFHVVLEOH SDVVHQJHU GURSRIIDUHDV DFFHVVLEOH SDUNLQJ VSDFHV DQG RWKHU DFFHVVLEOH HOHPHQWVOLNH D URXWH IURP D EXV VWRS WR DQ DFFHVVLEOH EXLOGLQJ HQWUDQFH7KH DFFHVVLEOH URXWH LV HVVHQWLDO IRU SHRSOH ZKR KDYH GLIÀFXOW\ZDONLQJ RU ZKR XVH ZKHHOFKDLUV RU RWKHU PRELOLW\ DLGV WR JHWWR WKH DFFHVVLEOH HQWUDQFH RI WKH VKHOWHU 7KH DFFHVVLEOH URXWHPXVW EH DW OHDVW  LQFKHV ZLGH LW PD\ QDUURZ EULHÁ\ WR LQFKHV ZLGH ZKHUH XWLOLW\ SROHV VLJQV HWF DUH ORFDWHG DORQJ WKHDFFHVVLEOH URXWH $EUXSW OHYHO FKDQJHV VWHSV RU VWHHS UXQQLQJRU FURVV VORSHV FDQQRW EH SDUW RI DQ DFFHVVLEOH URXWH :KHUHUDPSV DUH XVHG WKH\ FDQQRW EH VWHHSHU WKDQ  5DPSV ZLWK DYHUWLFDO ULVH RI PRUH WKDQ  LQFKHV PXVW KDYH KDQGUDLOV RQ ERWKVLGHV 5DPSV PXVW DOVR KDYH HGJH SURWHFWLRQ WR VWRS ZKHHOFKDLUVIURP IDOOLQJ RII WKH VLGHV DQG OHYHO ODQGLQJV DW WKH WRS DQGERWWRP RI HDFK VHJPHQW DQG ZKHUH WKH UDPS FKDQJHV GLUHFWLRQ

An accessible entrance to a shelter with accessible parking 

and an accessible drop-off area

ADA Emergency Shelter Checklist

19
C1-a. Is an accessible route provided from accessible parking spaces to the 

accessible entrance of the shelter? [ADA Standards § 4.1.2(1), 4.3]

C1-b. Is an accessible route provided from public sidewalks and public 

transportation stops on the shelter site (if provided) to the accessible entrance for the shelter? [ADA Standards § 4.1.2(1)] 

Note: The accessible route is at least 36 inches wide and may be a portion of a 

sidewalk. 

C1-c. Is the accessible route at least 36 inches wide? [ADA Standards § 4.3.3] 

If No, does the accessible route narrow to 32 inches for no more than 2 feet?

 C1-d. Is the accessible route free of steps and abrupt level changes higher than 

1/2 inch? [ADA Standards § 4.3.8]

Note: Level changes between 1/4 inch and 1/2 inch should be beveled (sloped) at 1:2maximum.

C1-e. Where an accessible route crosses a curb, is a curb ramp provided?

[ADA Standards § 4.3.8]e-i. Is the curb ramp surface at least 36 inches wide, excluding flared 

sides? [ADA Standards § 4.7.3]

e-ii. Is the running slope (up or down the ramp) no more than 1:12? 

 [ADA Standards § 4.7.2]

Note: 1:12 is one inch of vertical height for 12 inches of horizontal distance. 

C1-f. If the slope of part of the accessible route is more than 1:20, does it meet 

the following requirements for an accessible ramp?

Yes _____ No _____Yes _____ No _____Yes _____ No _____Yes _____ No _____Yes _____ No _____Yes _____ No _____

Yes _____ No _____

Notes/Comments

Yes _____ No _____

20

ADA Emergency Shelter Checklist
f-i. Is the running slope no greater than 1:12? [ADA Standards § 4.8.2]

Note: For existing ramps, the slope may be 1:10 for a 6-inch rise and 1:8 fora 3-inch rise in special circumstances (see ADA Standards § 4.1.6(3)).

f-ii. Are handrails installed on both sides of each ramp segment? 

[ADA Standards § 4.8.5]

f-iii. Is the ramp width, measured between the handrails, at least 36 

inches? [ADA Standards § 4.8.3]

f-iv. Does the ramp have a level landing at the top and bottom of each 

ramp section that is at least 60 inches long? [ADA Standards § 4.8.4] 

Note: The level landing may be part of the sidewalk or walking surface.

Yes _____ No _____

Yes _____ No _____

Yes _____ No _____Yes _____ No _____

ADA Emergency Shelter Checklist

21

Notes:

At least 36 inches between handrails

Top landing part of walk

Bottom landing part of walk

Handrail height 34 to 38 inches

Edge protection. 

Notes/Comments
Temporary Solutions For Emergency Sheltering - Ramps

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OHVV GLUHFW URXWH WKDW LV DFFHVVLEOH 'XULQJ DQ HYDFXDWLRQ LW ZLOO EH KHOSIXO WR SXW XS VLJQV RU WRKDYH YROXQWHHUV VWDWLRQHG DW WKH DFFHVVLEOH SDUNLQJ VSDFHV WR GLUHFW SHRSOH DORQJ WKLV OHVV GLUHFW EXWQRQHWKHOHVV DFFHVVLEOH URXWH

f-v. If a ramp is more than 30 feet long, is a level landing at least 60 

inches long provided at every 30 feet of horizontal length? [ADA Standards § 4.8.4] 

Note: if the running slope is less than 1:16 but more than 1:20, each rampsegment may be up to 40 feet long followed by a level landing].

f-vi. Is there a level landing, at least 60 inches x 60 inches, when a 

ramp changes direction? [ADA Standards § 4.8.4]

f-vii. Are the handrails mounted 34 to 38 inches above the ramp 

surface? [ADA Standards § 4.8.5]

f-viii. If the ramp or landing has a vertical drop-off on either side, is 

edge protection provided? [ADA Standards § 4.8.7]

Notes/Comments Yes _____ No _____

Yes _____ No _____

Yes _____ No _____

Yes _____ No _____

22

ADA Emergency Shelter Checklist
3UREOHP 7KH DFFHVVLEOH URXWH FURVVHV D FXUE EXW QR FXUE UDPS LV

SURYLGHG

6XJJHVWLRQ ,QVWDOO D SRUWDEOH UDPS ZLWK D VORSH QR VWHHSHU WKDQ 

ZLWK HGJH SURWHFWLRQ 6WRUH WKH SRUWDEOH UDPS RQ VLWH VRLW FDQ EH HDVLO\ DFFHVVHG LQ DQ HPHUJHQF\

A portable ramp with edge protection 

is installed over a curb to provide an 

accessible route.

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DFFHVVLEOH HQWUDQFH

6XJJHVWLRQ ,QVWDOO D SRUWDEOH UDPS ZLWK D VORSH QR VWHHSHU WKDQ 

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A portable ramp with edge protection and handrails is 

installed over two steps to provide an accessible route.

ADA Emergency Shelter Checklist

23
Notes:

The bottom of the handrail extensions turn down to 27 inches 

or less above the route so a person who is blind or has low 

vision can detect the hazard before running into it.

Signs or other objects in the pedestrian route can be a hazard if the 

bottom is more than 27 inches but less than 80 inches above the route.

Objects that overhang the pedestrian route must 

be at least 80 inches above the route.

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Common objects along pedestrian routes to a shelter that 

can be hazards to people who are blind or have low vision.

2. Typical Issues for Individuals Who Are Blind or Have Low Vision

24

ADA Emergency Shelter Checklist
C2-1. Are all sidewalks and walkways to the shelter free of any objects 

(e.g., wall-mounted boxes, signs, handrail extensions) with bottom edges that are between 27 inches and 80 inches above the walkway and that extend more than 4 inches into the sidewalk or walkway? 

[ADA Standards §§ 4.4, 4.2.1(3), 4.1.3(2)]

If No, can the object be lowered, removed, or modified or can the route be moved sothat the object can be avoided?

C2-2. Are the undersides of exterior stairs enclosed or protected with a canedetectable barrier so that people who are blind or have low vision will 

not hit their heads on the underside? [ADA Standards § 4.4.2]

If No, can a barrier or enclosure be added below the stair or can the route be relocatedaway from the stair?

When the underside of a stair is open, it is a hazard topeople who are blind or have low vision. Enclosing the area below the stair or installing a cane-detectable barrier helps this woman to stop before hitting her head.

Yes _____ No _____Yes _____ No _____

Notes/Comments

ADA Emergency Shelter Checklist

25
Overhead sign and tree branches are least 80 

inches above the walk.

C2-3. Are all objects that hang over 

the pedestrian routes at least 80 inches above the route? [ADA Standards § 4.4.2]

If No, can the objects be removedor relocated, or can a canedetectable object be added belowthat is at no higher than 27 inches?

Yes _____ No _____ Notes/Comments

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ZKR KDYH ORZ YLVLRQ

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26

ADA Emergency Shelter Checklist
Notes: 

Accessible entrance to the shelter.Accessible route connecting accessible parking and 

drop-off area (if provided) to the accessible entrance.

Building Entrance$ VKHOWHU PXVW KDYH DW OHDVW RQH DFFHVVLEOH HQWUDQFH WKDW LV RQ DQD. DFFHVVLEOH URXWH $Q DFFHVVLEOH HQWUDQFH PXVW SURYLGH DW OHDVW RQHDFFHVVLEOH GRRU ZLWK PDQHXYHULQJ VSDFH DFFHVVLEOH KDUGZDUH DQGHQRXJK FOHDU ZLGWK WR DOORZ SHRSOH ZKR XVH FUXWFKHV D FDQH ZDONHUVFRRWHU RU ZKHHOFKDLU WR XVH LW

 Entering the Emergency Shelter

Examples of signs for inaccessible 

shelter entrances directing people to

the accessible entrance.

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ADA Emergency Shelter Checklist

27
D1. Is there at least one accessible entrance connected to an accessible 

route? [ADA Standards § 4.1.3(1)]

Notes: If this entrance is not the main entrance, it needs to be kept unlocked whenother shelter entrances are unlocked. If there are inaccessible entrances serving the shelter, signs will be needed atinaccessible entrance(s) to direct evacuees to the nearest accessible entrance.

D2. Does at least one door or one side of a double leaf-door provide at 

least 32 inches clear passage width when the door is open 90 degrees? [ADA Standards § 4.13.5]

If No, does another entrance have an accessible door or can both doors be propped

open during the evacuation? Other possible solutions are to enlarge the door opening,use a swing clear hinge, or, if a double-leaf door, replace with uneven width doors.

D3. Is the hardware (e.g., lever, pull, and panic bar) usable with one 

hand without tight grasping, pinching, or twisting of the wrist? 

[ADA Standards § 4.13.9]

If No, leave door propped open, add new accessible hardware, or adapt/replacehardware. 

Yes _____ No _____ Notes/Comments

Yes _____ No _____

Yes _____ No _____

Examples of handles and door hardware that can be used without tight grasping, pinching, or twisting.

28

ADA Emergency Shelter Checklist
D4. On the latch, pull side of the door, is there at least 18 inches clearance 

provided if the door is not automatic or power-operated? [ADA Standards § 4.13.6, Fig. 25] 

If No, leave the door propped open or find another accessible entrance.

D5. If there is a raised threshold, is it no higher than 3/4 inch at the door and 

beveled on both sides? [ADA Standards §§ 4.1.6(3)(d)(ii), 4.13.8]

If No, replace threshold with one with beveled sides or add a sloped insert.

D6. If an entry has a vestibule, is there a 30-inch by 48-inch clear floor space 

inside the vestibule where a wheelchair or scooter user can be outside the swing of a hinged door? [ADA Standards § 4.13.7] 

If No, leave the inner door permanently open, remove inner door, or modify thevestibule.

Yes _____ No _____

Yes _____ No _____

Notes/Comments

Minimum vestibule depth of 48 inches if both 

doors open out

Minimum vestibule depth of 48 inches + door 

width when door swings into vestibule.

Yes _____ No _____

ADA Emergency Shelter Checklist

29
E. Hall

7KH LQWHULRU DFFHVVLEOH URXWH FRQQHFWV WKH DFFHVVLEOH HQWUDQFH ZLWK WKH YDULRXV VHUYLFH DQG DFWLYLW\ DUHDV ZLWKLQ WKH VKHOWHU 7\SLFDOO\ PDGHXS RI KDOOZD\V FRUULGRUV DQG LQWHULRU URRPV DQG VSDFHV WKH DFFHVVLEOH URXWH LV HVVHQWLDO IRU SHRSOH ZKR KDYH GLIÀFXOW\ ZDONLQJ RU ZKR XVHZKHHOFKDLUV RU RWKHU PRELOLW\ DLGV WR JHW WR DOO RI WKH VHUYLFH DQG DFWLYLW\ DUHDV RI WKH VKHOWHU

ways and Corridors

1. Typical Issues for Individuals Who Use Wheelchairs, Scooters, or Other Mobility Devices

Interior of a shelter showing the accessible route from the 

accessible entrance to all service and activity areas.

$Q DFFHVVLEOH URXWH LV DW OHDVW  LQFKHV ZLGH DQG PD\ QDUURZ EULHÁ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

:KHUH DQ DFFHVVLEOH URXWH LV GLIIHUHQW IURP WKH URXWH XVHG E\ PRVW HYDFXHHV VLJQV ZLOOEH QHHGHG DW NH\ GHFLVLRQ SRLQWV WR GLUHFW LQGLYLGXDOV ZLWK GLVDELOLWLHV WR WKH YDULRXVDFWLYLW\ DUHDV

Notes:

Accessible EntranceAccessible Route connects the 

accessible entrance with shelter 

service and activity area

Accessible door to service 

and activity areas

30

ADA Emergency Shelter Checklist
E1-a. Is there an accessible route, at least 36 inches wide, that connects the

accessible entrance to all shelter areas (it may narrow to 32 inches wide

for up to 2 feet in length)? [ADA Standards § 4.3.2(3)]

E1-b. Is the accessible route free of steps and abrupt level changes over 1/2

inch?

Note: level changes between 1/4 inch and 1/2 inch should be beveled).[ADA Standards §§ 4.1.3(1), 4.3.8]

E1-c. Does the accessible route from the accessible entrance to 

all activity areas change levels using a ramp, lift or elevator? 

[ADA Standards §§ 4.1.3(1), 4.3.8]

If No, go to question E1-g.

c-i. If Yes, is a ramp or sloped hallway provided?

If Yes, go to question E1-d.

c-ii. Is an elevator or lift provided?

If Yes, and the elevator or lift is part of the accessible route to a shelter area, isback-up electrical power available to operate the elevator or lift for the duration

of shelter operation should the normal electrical service be disrupted?If Yes and an elevator is provided, see question E1-e. 

If Yes and a lift is provided, see question E1-f. If No, then either provide back-up electrical power to operate the lift or elevator

during the power outage or locate shelter services exclusively on accessiblelevels that may be reached by people with a mobility disability without usingan elevator or lift.

Yes _____ No _____

Yes _____ No _____

Yes _____ No _____

Yes _____ No _____Yes _____ No _____

Notes/Comments

ADA Emergency Shelter Checklist

31
E1-d. Where the slope of the accessible route is greater than 1:20, does this 

area meet the following requirements for an accessible ramp?d-i. Is the slope no greater than 1:12? [ADA Standards § 4.8.2]

Note: For existing ramps, the slope may be 1:10 for a 6-inch rise and 1:8 fora 3-inch rise in special circumstances]. [ADA Standards § 4.1.6(3)

d-ii. Are handrails installed on both sides of each ramp segment? 

[ADA Standards § 4.8.5]

d-iii. Is the ramp width, measured between handrails, at least 36 

inches? [ADA Standards § 4.8.3]

d-iv. Are the handrails mounted 34 to 38 inches above the ramp 

surface? [ADA Standards § 4.8.5]

d-v. If a ramp is longer than 30 feet, is a level landing at least 60 inches 

long provided every 30 feet? [ADA Standards § 4.8.4]

d-vi. Does the ramp have a level landing that is at least 60 inches long 

at the top and bottom of each ramp section or where the ramp changes direction? [ADA Standards § 4.8.4]

d-vii. If the ramp or landing has a vertical drop-off on either side of the 

ramp, is edge protection provided? [ADA Standards § 4.8.7]

Yes _____ No _____Yes _____ No _____

Yes _____ No _____

Yes _____ No _____Yes _____ No _____Yes _____ No _____

Yes _____ No _____Yes _____ No _____

Notes/Comments

32

ADA Emergency Shelter Checklist
E1-e. Is an elevator provided to each of the levels on which each sheltering 

service or activity area is located?e-i. Are the centerlines of the call buttons mounted 42 inches above 

the floor? [ADA Standards § 4.10.3]

e-ii. Does the floor area of the elevator car have space to enter, reach 

the controls, and exit? [ADA Standards § 4.10.9, Fig. 22] 

e-iii. Can the elevator be called and operated automatically without 

using a special key or having to turn on the elevator from a remote location? [ADA Standards § 4.10.2] 

Yes _____ No _____Yes _____ No _____

Yes _____ No _____

Note: See Figure 22 for acceptable floor and opening dimensions. Floor dimensions of at least48 inches by 48 inches may be allowed in existing facilities built before the ADA went into effect.

Notes/Comments

Yes _____ No _____

ADA Emergency Shelter Checklist

33
e-iv. Are the highest floor control buttons mounted no more than 54 

inches above the floor for a side reach or 48 inches for forward reach? [ADA Standards § 4.10.12 (3)]

e-v. Are raised letters and Braille characters used to identify each floor 

button and each control? [ADA Standards § 4.10.12]

e-vi. Are signs mounted on both sides of the elevator hoistway door 

opening (for each elevator and at each floor) that designate 

the floor with 2-inch minimum-height raised letters and Braille characters centered at 60 inches above the floor?  [ADA Standards § 4.10.5]

e-vii. Is the elevator equipped with audible tones or bells or verbal 

annunciators that announce each floor as it is passed? [ADA Standards § 4.10.13]

E1-f. If a wheelchair lift is provided, does it meet the following?

f-i. Is the lift operational at the time of the survey? 

[ADA Standards § 4.11.3]

f-ii. Is the change in level from the floor to the lift surface ramped or 

beveled? [ADA Standards §§ 4.11.2, 4.5.2]

f-iii. Is there at least a 30-inch by 48-inch clear floor space on the 

wheelchair lift? [ADA Standards §§ 4.11.2, 4.2.4]

f-iv. Does the lift allow a person using a mobility device unassisted 

entry, operation (is key available, if required), and exit? 

Yes _____ No _____

Yes _____ No _____

Yes _____ No _____Yes _____ No _____

Yes _____ No _____Yes _____ No _____Yes _____ No _____

Notes/Comments

Yes _____ No _____Yes _____ No _____

34

ADA Emergency Shelter Checklist
f-v. Are the controls and operating mechanisms mounted no more 

than 54 inches above the floor for a side reach or 48 inches for a forward reach? [ADA Standards §§ 4.11.2, 4.27.3]

f-vi. Are the controls and operating mechanisms usable with 

one hand without tight grasping, pinching, or twisting? 

[ADA Standards §§ 4.11.2, 4.27.4]

E1-g. At each location on the way to each shelter activity area where the 

accessible route passes through a door, does at least one door meet the following requirements?g-i. Is the clear width for the door opening at least 32 

inches measured when the door is open 90 degrees? [ADA Standards §§ 4.1.3(7), 4.13.5]

g-ii. Is the door hardware (e.g., lever, pull, push, panic bar) 

usable with one hand, without tight grasping, pinching, or twisting of the wrist, to allow people who may not be able to easily use one or both hands to fully operate the hardware? [ADA Standards § 4.13.9]

Yes _____ No _____Yes _____ No _____

Yes _____ No _____

Notes/Comments

Yes _____ No _____Yes _____ No _____

ADA Emergency Shelter Checklist

35
A clear floor space on the latch side of the door (pull side) allows a person using a 

wheelchair or scooter to pull the door open and then enter. The size of the clear floor space 

varies depending on the direction of approach (shown by the arrows) and the door swing.

g-iii. Is there clear maneuvering floor space in front of each accessible 

door (see ADA Standards § Fig. 25) and, on the pull side, is there at least 18 inches clear floor space beyond the latch side of the door (see space configurations in Figure 25)? [ADA Standards § 4.13.6]

Yes _____ No _____Yes _____ No _____

Yes _____ No _____

Notes/Comments

g-iv. Is no more than 5 pounds force needed to push or pull open the 

door? [ADA Standards § 4.13.11 (2)(b)]

Note: Fire doors are still considered to be accessible if they have theminimum opening force allowable by the appropriate administrativeauthority.

g-v. If the answers to questions g-ii thru g-iv are No, can the door be 

propped open? 

If an activity area is not on an accessible route and cannot be made accessible, find another area that is on an accessible route where that activity may be provided.

36

ADA Emergency Shelter Checklist
,QGLYLGXDOV ZKR DUH EOLQG RU KDYH ORZ YLVLRQ PD\ ZDON DORQJ DQ\ URXWH RU WKURXJK

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ÁRRU DQG VLGH REMHFWVWKDW SURWUXGH LQWR WKH URXWH PRUH WKDQ  LQFKHV ZKHQ WKH ERWWRP RI WKH REMHFW LVPRUH WKDQ  LQFKHV DERYH WKH ÁRRU ,WHPV WR ZDWFK IRU LQFOXGH ZDOOPRXQWHG ÀUHH[WLQJXLVKHUV DQG ZDOOPRXQWHG GLVSOD\ FDVHV ZKHQ WKH ERWWRP LV PRUH WKDQ LQFKHV DERYH WKH ÁRRU ZDOO VFRQFHV DQG OLJKW À[WXUHV WKDW SURWUXGH PRUH WKDQ LQFKHV RII WKH ZDOO DQG RSHQ VWDLUFDVHV H[LW VLJQV RYHUKHDG VLJQV EDQQHUV DQGDUFKHG GRRUZD\V WKDW DUH ORZHU WKDQ  LQFKHV DERYH WKH ÁRRU

2. Typical Issues for People Who are Blind or Have Low Vision

Notes:

Wall-mounted drinking fountains are a hazard when the front projects more than 

4 inches beyond the wall and the bottom is more than 27 inches above the floor.

Wall-mounted objects cannot project more than 4 inches beyond the wall if 

the bottom is not in the cane-detectable area below 27 inches off the floor.

Overhead objects must be at least 80 inches off the floor.

Overhead and wall-mounted objects that may be 

hazards along a pedestrian route

ADA Emergency Shelter Checklist

37
7KH IROORZLQJ TXHVWLRQV DSSO\ WR SHGHVWULDQ URXWHV VHUYLQJ RU OHDGLQJ WR WKH VKHOWHU DFWLYLW\ DQG FRPPRQ XVH

DUHDV

E2-a. Are pedestrian routes leading to or serving each service or activity area of 

the shelter free of objects that protrude from the side more than 4 inches into the route with the bottom of the object more than 27 inches above the floor? [ADA Standards § 4.4.1] 

Note: These objects may be wall mounted or free standing. Items to check include

wall-mounted fire extinguishers, light fixtures, coat hooks, shelves, drinkingfountains, and display cases.

E2-b. Are pedestrian routes leading to or serving each of the service or activity 

areas free of overhead objects with the bottom edge lower than 80 inches above the floor? [ADA Standards § 4.4.2]

E2-c. Are any interior stairs along these routes configured with a cane-detectable warning or a barrier that prevents travel into the area with less than an 80-inch high head clearance so that people who are blind or who have low vision cannot hit their heads on the underside or stair frame? [ADA Standards § 4.4.2]

If No, list the objects that are a hazard and theirlocation. Remove or relocate the object or place a detectable object on the floor below each object toremove the hazard.

Yes _____ No _____Yes _____ No _____

Yes _____ No _____

Notes/Comments

38

ADA Emergency Shelter Checklist

When the underside of a stair is open, 

it is a hazard to people who are blind 

or have low vision. Enclosing the area 

below the stair or installing a canedetectable barrier helps the person to

avoid the area.
F1. Is there an accessible route that connects the accessible entrance to 

areas that are likely to be used to register people as they arrive at the shelter? [ADA Standards § 4.3]

F2. If there is a built-in reception or other type of counter, does it have a 

section that is at least three feet long that is no higher than 36 inches above the floor or is there a nearby surface that is not higher than 36 inches above the floor? [ADA Standards § 7.2]

Yes _____ No _____

Yes _____ No _____

Notes/Comments

ADA Emergency Shelter Checklist

F.

39

 Check-In Areas

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ÁRRU D IROGLQJ VKHOI RU DQDGMDFHQW WDEOH RU D FOLS ERDUG

An accessible check-in location using a folding table with a 

height that people who use wheelchairs can easily reach.
G. Sleeping Areas

(DFK DFFHVVLEOH VOHHSLQJ DUHD QHHGV WREH RQ DQ DFFHVVLEOH URXWH FRQQHFWLQJ LW WRRWKHU DFWLYLW\ DUHDV LQ WKH VKHOWHU LQFOXGLQJWRLOHW URRPV DQG EDWKLQJ DUHDV $QDFFHVVLEOH URXWH ZLWK DGHTXDWH FLUFXODWLRQDQG PDQHXYHULQJ VSDFH SURYLGHV DFFHVVLQ WKH VOHHSLQJ DUHDV IRU SHRSOH ZKR XVHZKHHOFKDLUV RU VFRRWHUV DQG WKLV URXWH VHUYHVHDFK DFFHVVLEOH EHG RU FRW

Interior of one section of a shelter’s sleeping 

area. The shaded pathway indicates the 

accessible route, which provides access to

accessible beds, cots, and other activity areas 

in the space plus the toilet rooms and other 

activity areas in the shelter.

40

ADA Emergency Shelter Checklist

Living at the Emergency Shelter
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An accessible cot positioned against a wall. Dashed 

lines indicate the accessible route and clear floor 

space next to the cot.

G1. Is there an accessible route, at least 36 inches wide, that connects each 

sleeping area with other shelter activity areas? 

Note: it may narrow to 32 inches wide for up to 2 feet in length.[ADA Standards § 4.3.2(3)]

G2. Is the accessible route free of steps and abrupt level changes over 1/2 inch?

Note: level changes between 1/4 inch and 1/2 inch should be beveled.[ADA Standards §§ 4.1.3(1), 4.3.8]Note: Although the facility survey cannot check the accessibility of the cotsbecause they will not be installed until the shelter is in use, planning for setting upthe sleeping area and for arranging the cots and mats should include providingspace for an accessible route and clear floor space at each accessible cot. Cotsused by people who are blind or who have low vision should be in an easilylocatable area.

Yes _____ No _____

Yes _____ No _____

Notes/Comments

ADA Emergency Shelter Checklist

41
H. Restrooms and Showers

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Interior of an accessible toilet room showing accessible route, clear 

floor space at accessible fixtures, and the wide accessible toilet stall.

H1. If a sign is provided at the toilet room entrance (e.g. Men, Women, Boys, 

Girls, etc.), is a sign with raised characters and Braille mounted on the wall adjacent to the latch? [ADA Standards § 4.30.6]

If No, install a sign with raised characters and Braille on the wall adjacent to the latch side of the door and centered 60 inches above the floor and leave the existing sign inplace on the door if removing it will damage the door.

Note: an additional sign may be mounted on the toilet room door but this cannot be

considered to be the accessible sign which must be mounted on the wall adjacent tothe latch side of the door.

Yes _____ No _____

Notes/Comments

42

ADA Emergency Shelter Checklist
H2. Does the door to the toilet room provide at least 32 inches clear passage 

width when the door is open 90 degrees? [ADA Standards § 4.13.5]

H3. Is the hardware (e.g., lever, pull, panic bar) usable with one hand without 

tight grasping, pinching, or twisting of the wrist? 

 [ADA Standards § 4.13.9]

If No, can the door be propped open without compromising privacy, or can the

hardware be modified by adding new accessible hardware, or adapting or replacinghardware? 

H4. On the pull side of the door, is there at least 18 inches clearance provided 

on the latch side if the door is not automatic or power-operated? 

 [ADA Standards § 4.13.6, Fig. 25]H5. If there is a raised threshold, is it no higher than 3/4 inch at the door and 

beveled on both sides? [ADA Standards §§ 4.1.6(3)(d)(ii), 4.13.8]

If No, replace threshold with one with beveled sides or add a sloped insert.

H6. If the entry has a vestibule, is there a 30-inch by 48-inch clear floor space 

inside the vestibule where a wheelchair or scooter user can be outside the door swing? [ADA Standards § 4.13.7] 

If No, possible solutions include leaving the inner door open or removing the outerdoor.

Yes _____ No _____Yes _____ No _____

Yes _____ No _____Yes __ No___ NA__Yes _____ No _____

Notes/Comments

ADA Emergency Shelter Checklist

43
Minimum spaces for turning

H8. If lavatories are provided, does at least one have at least a 29 inch high 

clearance under the front apron with the top of the rim no more than 34 inches above the floor? [ADA Standards § 4.19.2]

H9. Are the drain and hot water pipes for this lavatory insulated or otherwise 

configured to protect against contact? [ADA Standards § 4.19.4]

Yes _____ No _____

H7. Inside the toilet room, is there an area where a person who uses a 

wheelchair or other mobility device can turn around - either at least a 60-inch diameter circle or a “T”-shaped turn area as shown in the figures 

below? [ADA Standards §§ 4.22.3; 4.2.3]

Yes _____ No _____ Notes/Comments

Yes _____ No _____

44

ADA Emergency Shelter Checklist
H10. Does this lavatory have controls that operate easily with one 

hand, without tight grasping, pinching, or twisting of the wrist? 

[ADA Standards § 4.19.5]

H11. If mirrors are provided, is the bottom of the reflecting surface for the 

mirror at this lavatory no higher than 40 inches above the floor or is a full length mirror provided? [ADA Standards § 4.19.6]

H12. For at least one of each type of dispenser, receptacle, or equipment, is 

there clear floor space at least 30 inches wide x 48 inches long adjacent to the control or dispenser (positioned either parallel to the control or dispenser or in front of it)?  [ADA Standards §§ 4.23.7; 4.27.2; 4.2.5 and Fig 5; 4.2.6 and Fig 6] 

H13. Is the operating control (switch, lever, button, or pull) of at least one of 

each type of dispenser or built-in equipment no higher than 54 inches above the floor (if there is clear floor space for a parallel approach) or 48 inches (if there is clear floor space for a front approach)? 

[ADA Standards §§ 4.23.7; 4.27.3; 4.2.5 and Fig 5; 4.2.6 and Fig 6] 

H14. Are all built-in dispensers, receptacles, or equipment mounted so 

the front does not extend more than 4 inches from the wall if the bottom edge is between 27 inches and 80 inches above the floor? [ADA Standards §§ 4.23.7; 4.27; 4.4.1; Fig. 8] 

Yes _____ No _____

Yes _____ No _____

Yes _____ No _____Yes _____ No _____

Yes _____ No _____

Notes/Comments

ADA Emergency Shelter Checklist

45
Toilet Stalls 

H15. Is at least one wide toilet stall 

provided with an outswinging door, side and rear grab bars, 

and clear space next to the toilet? [ADA Standards § 4.17] 

If No, check to see if another toilet

room provides a wide accessibletoilet stall, note its location forshelter planners, and answer all toilet

room questions with respect to thattoilet room.

Overhead view of an individual using a 

wheelchair positioned beside a toilet in a 

wide accessible stall.

Yes _____ No _____

H16. Is the toilet stall at least 60 inches wide and 56 inches deep 

(wall mounted toilet) or 59 inches deep (floor mounted toilet)? [ADA Standards § 4.17.3]

If No, note the width and depth of the stall. _________________

H17. Is at least 9 inches of toe clearance provided under the front wall and at 

least one side wall of the toilet stall? [ADA Standards § 4.17.4]

H18. Is the centerline of the toilet 18 inches from the adjacent side wall? 

[ADA Standards § 4.16.2; 4.17.3]

Yes _____ No _____

Yes _____ No _____Yes _____ No _____

Notes/Comments

46

ADA Emergency Shelter Checklist
H19. Is the top of the toilet seat 17 inches to 19 inches above the floor? 

[ADA Standards § 4.16.3]

H20. Is the flush valve located on the wide side adjacent to the lavatory or is 

an automatic flush valve provided? [ADA Standards § 4.16.5] 

H21. Is a horizontal grab bar at least 40 inches long securely mounted on 

the adjacent side wall 33 to 36 inches above the floor with one end no more than 12 inches from the back wall 33 to 36 inches above the floor? 

[ADA Standards § 4.16.4; 4.17.6]

H22. Is a second horizontal grab bar at least 36 inches long securely mounted 

on the back wall with one end no more than 6 inches from the side wall 33 to 36 inches above the floor? [ADA Standards § 4.16.4; 4.17.6]

H23. Is the door to the toilet stall located diagonally opposite, not directly in 

front of, the toilet or on the opposite side wall from the wall with the long grab bar? [ADA Standards § 4.17.3]

Yes _____ No _____Yes _____ No _____Yes _____ No _____

Notes/Comments

Yes _____ No _____

Yes _____ No _____

Plan views showing minimum sizes of wide 

accessible toilet stall

Yes _____ No _____ H24. Unless the wide stall is 

located at the end of a row of toilet stalls, 

 does the door to this 

wider stall open out? [ADA Standards § 4.17.3]

ADA Emergency Shelter Checklist

47
H25. Is the clear width of the door at least 32 inches (measured between the 

face of the door and the edge of the opening) when the door is open 90 degrees? [ADA Standards § 4.13.5]

H26. If there are 6 or more stalls in the restroom, is one of those stalls (in 

addition to the wider stall noted above) exactly 36 inches wide with an 

outswinging stall door that provides at least 32 inches of clear width? 

[ADA Standards § 4.22.4]

H27. Does this 36-inch wide stall have horizontal grab bars on both of the side 

partitions that are at least 36 inches long and 33 to 36 inches above the floor? [ADA Standards § 4.22.4]

H28. Is the surface of the toilet seat in this 36-inch-wide stall 17 to 19 inches 

above the floor? [ADA Standards §§ 4.16.3; 4.22.4]

H29. If a coat hook is provided is it mounted no higher than 54 inches above 

the floor for a side approach or 48 inches above the floor for a front approach? [ADA Standards § 4.25.3]

Yes _____ No _____

Yes _____ No _____

Yes _____ No _____

Yes _____ No _____

Yes _____ No _____

Notes/Comments

48

ADA Emergency Shelter Checklist
7KH IROORZLQJ DUH ¿JXUHV LOOXVWUDWLQJ VRPH DFFHVVLEOH VKRZHU IHDWXUHV IURP WKH $'$ 6WDQGDUGV

Accessible Shower Stall 

Minimum Size and Clearances

Accessible Shower Stall Grab Bars 

and Seat, Shower, and Control Area

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ADA Emergency Shelter Checklist

49
I. Public Telephones 

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

I1. If at least one public telephone or one bank of telephones is provided, 

does at least one of each type of telephone (e.g., pay telephone, intercom telephone, other telephone) have the following?I1a. For a side approach (clear floor space at least 30 inches long x 48 

inches wide), is the coin slot no higher than 54 inches above the floor? [ADA Standards § 4.31.2, Fig. 44 (a)]

I1b. For a front approach (where clear floor space at least 30 inches 

wide x 48 inches long), is the coin slot no higher than 48 inches above the floor? [ADA Standards § 4.31.2, Fig. 44 (b)]

I2. Does the phone have volume controls? [ADA Standards § 4.31.5] 

Yes _____ No _____Yes _____ No _____

Notes/Comments

Yes _____ No _____

Yes _____ No _____

50

ADA Emergency Shelter Checklist
I3. If three or more telephones are located in one bank serving the shelter, 

are a shelf and an electrical outlet provided at one telephone for use of a portable TTY? [ADA Standards § 4.31.9 (2)]

I4. If four or more pay telephones are provided on the site, is there a TTY 

(text telephone) provided at the shelter? 

I5. Is there a sign at each pay phone or pay phone bank for the shelter 

directing people to the nearest TTY? [ADA Standards § 4.30.7 (3); 4.31.9(3)]

Yes _____ No _____

Yes ____ No _____ If yes, location: ________________

Yes _____ No _____

Notes/Comments

A bank of two public telephones. The accessible telephone is on the left and the telephone on the right is equipped with a TTY.

ADA Emergency Shelter Checklist

51
J. Drinking Fountains 

$SSUR[LPDWHO\  RI WKH GULQNLQJ IRXQWDLQV VHUYLQJ WKH VKHOWHU PXVW EH DFFHVVLEOH DQG ORFDWHG RQ DQ DFFHVVLEOHURXWH $FFHVVLEOH GULQNLQJ IRXQWDLQV PXVW KDYH HQRXJK VSDFH IRU D SHUVRQ XVLQJ D ZKHHOFKDLU VFRRWHU RU RWKHUPRELOLW\ GHYLFH WR XVH WKH GULQNLQJ IRXQWDLQ 7KH VSRXW DQG FRQWUROV RI WKH GULQNLQJ IRXQWDLQ PXVW EH QHDU WKHIURQW HGJH 7KH FRQWUROV PXVW EH XVDEOH ZLWK RQH KDQG ZLWKRXW WLJKW JUDVSLQJ SLQFKLQJ RU WZLVWLQJ RI WKH ZULVW7KH RWKHU  RI GULQNLQJ IRXQWDLQV VHUYLQJ WKH VKHOWHU PXVW EH FRQÀJXUHG IRU XVH E\ SHRSOH ZKR KDYH GLIÀFXOW\EHQGLQJ RU VWRRSLQJ ZKLOH VWDQGLQJ:KHQ DQ REMHFW VXFK DV D GULQNLQJ IRXQWDLQ SURWUXGHV PRUH WKDQ IRXU LQFKHV LQWR WKH FLUFXODWLRQ SDWK WKH ERWWRPHGJH PXVW EH DW  LQFKHV DERYH WKH ÁRRU RU ORZHU VR WKH GULQNLQJ IRXQWDLQ LV QRW D KD]DUG WR SHRSOH ZKR DUH EOLQGRU KDYH ORZ YLVLRQ

Notes/Comments

A person who uses a wheelchair is drinking from an accessible drinking fountain. Beside the accessible drinking fountain is a standard height fountain that is usable by people who have difficulty bending or stooping. The short wall beside the standard height drinking fountain is cane detectable to guide people who are blind or have low vision away from the standard height fountain which, otherwise, would be a protruding object hazard.

52

ADA Emergency Shelter Checklist
7KH IROORZLQJ TXHVWLRQV DSSO\ WR  RI WKH GULQNLQJ IRXQWDLQV WKDW DUH SURYLGHG

J1. If the drinking fountain is a wall-mounted unit, is there clear floor space 

at least 30 inches wide (36 inches if it is in an alcove) x 48 inches long in front of the drinking fountain and at least 27 inches high under the fountain so that a person using a wheelchair can get close to the spout and controls? [ADA Standards § 4.15.5 (1), Figs. 4 (e) and 27 (b)]

J2. If the drinking fountain is a floor-mounted unit, is there clear floor space 

at least 30 inches long x 48 inches wide (60 inches if it is in an alcove) for a side approach to the drinking fountain so that a person using a wheelchair can get close to the spout and controls even though the fountain has no clear space under it?  [ADA Standards § 4.15.5 (2), Figs. 4 (e), 27 (c) and (d)] 

J3. Is the top of the spout no higher than 36 inches above the floor and at 

the front of the fountain or water cooler? [ADA Standards § 4.15.2]

J4. Does the water rise at least 4 inches high when no more than 

5 pounds of force is applied to the controls of the fountain? 

[ADA Standards §§ 4.15.3 and 4.15.4]

J5. Are the controls on or near the front of the unit and do they operate 

with one hand without tight grasping, pinching, or twisting of the wrist? [ADA Standards § 4.15.4]

J6. Is the bottom of the apron of the fountain 27 inches above the 

floor so that it provides the space needed for a person who uses a wheelchair to pull up under it but is not a hazard to people who are blind or have low vision and use a cane to detect hazards? 

[ADA Standards §§ 4.15.5 (1) and 4.4.1]

Yes _____ No _____

Yes _____ No _____

Notes/Comments

Yes _____ No _____

Yes _____ No _____

Yes _____ No _____

Yes _____ No _____

ADA Emergency Shelter Checklist

53
K. Eating Areas

$Q DFFHVVLEOH URXWH DW OHDVW  LQFKHV ZLGH DQG ZLWKRXW VWHSV RU VWHHS VORSHV PXVW EHSURYLGHG WR DQG WKURXJKRXW WKH IRRG VHUYLFH DQG HDWLQJ DUHDV RI WKH VKHOWHU 7KH DFFHVVLEOHURXWH DOORZV SHRSOH ZKR XVH ZKHHOFKDLUV VFRRWHUV DQG RWKHU PRELOLW\ GHYLFHV WR JHW WR DOORI WKH IRRG DQG GULQN LWHPV LQ WKH VKHOWHU DQG WR DFFHVVLEOH WDEOHV DQG VHDWLQJ

A serving and eating area in a shelter are shown above. The shaded pathway

illustrates the accessible route connecting the entrance, serving areas, 

accessible seats and tables, and the exit.

Notes/Comments

54

ADA Emergency Shelter Checklist
K1. Is there an accessible route, at least 36 inches wide, that connects each 

of the shelter activity areas with the food service and eating areas (it may narrow to 32 inches wide for up to 2 feet in length)? [ADA Standards § 4.3.2(3)]

K2. Is there an accessible route that is at least 36 inches wide that connects 

accessible tables with serving, condiment, and dispenser areas? [ADA Standards § 5.3; 4.3.8]

K3. In each eating area, if tables with fixed seats are provided, do at least 

5% of each type of table with fixed seats have accessible locations with knee space at least 27 inches high, at least 19 inches deep, and at 

least 30 inches wide with a table top 28 to 34 inches above the floor? [ADA Standards § 5.1] 

Note: If movable tables and chairs are used as shown, then locate at least 5% of thetables adjacent to an accessible route. 

Tables can be relocated as needed during

operation of the shelter.

K4. If built-in food, drink, condiment, and tableware dispensers are provided, 

are dispensers and operating controls mounted no higher than 54 inches above the floor if clear floor space is provided for a side approach? [ADA Standards § 5.5] 

K5. If the operating controls are set back 10 to 24 inches from the front edge 

of the counter or table are they no higher than 46 inches above the floor? [ADA Standards § 5.5]

K6. If food service lines are provided, is an accessible route provided (at 

least 36 inches wide) and are the tray slides no higher than 34 inches above the floor? [ADA Standards § 5.5] 

Yes _____ No _____Yes _____ No _____Yes _____ No _____Yes _____ No _____

Notes/Comments

Yes _____ No _____

Yes _____ No _____

ADA Emergency Shelter Checklist

55
L. Availability of Electrical Power

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

Yes _____ No _____Yes _____ No _____

OTHER ISSUES Notes/Comments

L1. Is there a backup source of electrical power for the facility? L2. Is there a refrigerator or other equipment, such as coolers with a good 

supply of ice, at the shelter? 

56

ADA Emergency Shelter Checklist
M. Single-User or “Family” Toilet Room

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́IDPLO\μ WRLOHW URRP :KHQ SURYLGHG LQ DGGLWLRQ WR ODUJHDFFHVVLEOH WRLOHW URRPV WKLV W\SH RI IDFLOLW\ SHUPLWV D SHUVRQ ZLWK D GLVDELOLW\ WR UHFHLYH DVVLVWDQFH IURP D SHUVRQRI WKH RSSRVLWH VH[

Notes/Comments

Yes _____ No _____

M1. If a sign is provided at the toilet room entrance (e.g. Men, Women, Boys, 

Girls, etc.), is a sign with raised characters and Braille mounted on the wall adjacent to the latch side of the door and centered 60 inches above the floor? [ADA Standards § 4.1.3(16)(a)] 

If No, install a sign with raised characters and Braille on the wall adjacent to the latch side of the door and centered 60 inches above the floor and leave the existing sign inplace on the door if removing it will damage the door.

Note: an additional sign may be mounted on the toilet room door but this cannot be

considered to be the accessible sign which must be mounted on the wall adjacent tothe latch side of the door.

M2. Does the door to the toilet room provide at least 32 inches clear passage 

width when the door is open 90 degrees? [ADA Standards § 4.13.5]

M3. Is the hardware (e.g., lever, pull, etc.) usable with one hand without tight 

grasping, pinching, or twisting of the wrist? [ADA Standards § 4.13.9]

If No, add new accessible hardware or adapt/replace hardware. 

Yes _____ No _____Yes _____ No _____

ADA Emergency Shelter Checklist

57
M4. On the latch, pull side of the door, is there at least 18 inches 

clearance provided if the door is not automatic or power operated? 

[ADA Standards § 4.13.6; Fig. 25]

M5. If there is a raised threshold, is it no higher than 3/4 inch at the door and 

beveled on both sides? [ADA Standards §§ 4.1.6(3)(d)(ii); 4.13.8]

If No, replace threshold with one with beveled sides or add a sloped insert.

M6. Inside the room is there an area for a person who uses a wheelchair to 

turn around - either a 60-inch diameter circle or a “T”-shaped turn area? [ADA Standards §§ 4.22.3; 4.2.3]

M7. If the door swings into the room, does the door swing not 

overlap the required clear floor space for the toilet or lavatory? [ADA Standards §§ 4.22.2; 4.2.4.1]

Note: In the figure below the clear floor space for the toilet extends at least 66inches from the back wall.

Yes _____ No _____

Yes _____ No _____Yes _____ No _____Yes _____ No _____

Notes/Comments

Yes _____ No _____Yes _____ No _____

Plan view showing the minimum amount 

of space required between the toilet and 

the adjacent lavatory.

M8. Is there at least 18 inches 

between the center of the toilet and the side of the adjacent lavatory? [ADA Standards § 4.16.2; Fig. 28]

M9. Does the lavatory have at least 

a 29-inch-high clearance under the front edge and the top of the rim no more than 34 inches above the floor? [ADA Standards § 4.19.2]

58

ADA Emergency Shelter Checklist
Notes:

48-inch minimum by 

66-inch minimum clear 

floor space for toilet

48-inch minimum by 

30-inch minimum clear 

floor space for lavatory

60-inch minimum 

turning space

door swing

Yes _____ No _____

M10. Are the drain and hot water pipes for the lavatory insulated or otherwise 

configured to protect against contact? [ADA Standards § 4.19.4]

M11. Does that lavatory have controls that operate easily with one hand, 

without tight grasping, pinching, or twisting of the wrist? [ADA Standards § 4.19.5]

Plan view of a single-user toilet room showing the door swing not overlapping 

the dark toned area indicating the clear floor space for the toilet and lavatory. 

The door swing may overlap the turning space indicated by the circular area.

Notes/Comments

Yes _____ No _____

ADA Emergency Shelter Checklist

59
M12. If a mirror is provided, is the bottom of 

the reflecting surface no higher than 40 inches above the floor or is a full length mirror provided? [ADA Standards § 4.19.6]

M13. For each type of dispenser, receptacle, 

or equipment, is there clear floor space at least 30 inches wide x 48 inches long 

adjacent to the control or dispenser (positioned either parallel to the control or dispenser or in front of it)? [ADA Standards §§ 4.23.7; 4.27.2; 4.2.5 and Fig 5; 4.2.6 and Fig 6]

M14. Is the operating control (switch, lever, 

button, or pull) for each type of dispenser or built-in equipment no higher than 54 inches above the floor (if there is clear floor space for a parallel approach) or 48 inches (if there is clear floor space for a front approach)?  [ADA Standards § 4.23.7; 4.27.3; 4.27.2; 4.2.5 and Fig 5; 4.2.6 and Fig 6]

M15. Are all built-in dispensers, receptacles, or equipment mounted so the 

front does not extend more than 4 inches from the wall if the bottom 

edge is between 27 inches and 80 inches above the floor? [ADA Standards §§ 4.23.7; 4.27; 4.4.1; Fig. 8]

M16. Is the centerline of the toilet 18 inches from the adjacent side wall? 

[ADA Standards § 4.16.2; 4.17.3] 

Yes _____ No _____Yes _____ No _____

Yes _____ No _____Yes _____ No _____Yes _____ No _____

Notes/Comments

60

ADA Emergency Shelter Checklist

Front view of toilet, lavatory, 

mirror and soap dispenser
M17. Is the top of the toilet seat 17 to 19 inches above the floor? 

[ADA Standards § 4.16.3]

M18. Is the flush valve located on the side adjacent to the lavatory? 

[ADA Standards § 4.16.5] 

M19. Is a horizontal grab bar at least 40 inches long securely mounted on 

the adjacent side wall 33 to 36 inches above the floor with one end no more than 12 inches from the back wall? [ADA Standards §§ 4.16.4; 4.17.6]

M20. Is there a horizontal grab bar at least 36 inches long securely mounted 

behind the toilet 33 to 36 inches above the floor with one end no more than 6 inches from the side wall? [ADA Standards §§ 4.16.4; 4.17.6]

M21. If a coat hook is provided, is it mounted no higher than 54 inches 

above the floor for a side approach or 48 inches above the floor for a front approach? [ADA Standards § 4.25.3]

Yes _____ No _____

Yes _____ No _____Yes _____ No _____

Yes _____ No _____

Notes/Comments

Yes _____ No _____

ADA Emergency Shelter Checklist

61
,Q PDQ\ VFKRROV ZKHUH HPHUJHQF\ VKHOWHUV

DUH RIWHQ ORFDWHG QXUVHV· URRPV RU RWKHU W\SHVRI KHDOWK FDUH IDFLOLWLHV PD\ EH SURYLGHG7KHVH KHDOWK FDUH IDFLOLWLHV VKRXOG EH RQDQ DFFHVVLEOH URXWH DQG KDYH DFFHVVLEOHIHDWXUHV LQFOXGLQJ DQ DFFHVVLEOH HQWUDQFHDQ DFFHVVLEOH URXWH WR WKH GLIIHUHQW W\SHV RIVHUYLFHV RIIHUHG ZLWKLQ WKH PHGLFDO FDUH XQLWWXUQLQJ DQG PDQHXYHULQJ VSDFHV DQG FRWV RUEHGV WKDW DUH DW D KHLJKW WR ZKLFK SHRSOH ZKRXVH PRELOLW\ GHYLFHV FDQ HDVLO\ WUDQVIHUN. Health Units/Medical Care Areas

An overhead view of a medical care area with a shaded pathway

showing the accessible route shown and clear floor spaces.

N1. Is there an accessible route, at least 36 inches wide, that connects 

each of the shelter activity areas with the health units and medical care areas (it may narrow to 32 inches wide for up to 2 feet in length)? 

[ADA Standards § 4.3.2(3)]

Yes _____ No _____

Notes/Comments

62

ADA Emergency Shelter Checklist
O. Accessible Portable Toilets

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

A person using a wheelchair enters an accessible 

portable toilet. The unit is positioned to provide a 

flush entry from the accessible route.

ADA Emergency Shelter Checklist

63
115

Appendix 2

FORM: Contact Information for Shelter Services Providers

This is a small sample of the services you should have in place prior to an emergency or disaster

Services for Persons 

Requiring FNSS Account Number Vendor Name Address Telephone

Communications Providers

Interpreters (Spanish, sign 

language, etc.)

Television with Captioning

Information Technology/

Computer Services

TTY – TDD

Computer Assisted Real time 

Translation (CART)

Note Taking

Medical Staffing Services 

Onsite Nursing Services

Emergency Medical Services

Mental Health Services 

Emergency Dental Services

Pharmaceutical Services

Resource Suppliers 

O2 

Dialysis

Constant Power Source

Blood Sugar Monitoring
116

Food Services 

Special Diets

Caterer

Personal Assistance Services

Transportation Services

Para transit Services

Public Transportation

Service Animals

Emergency Veterinary 

Services

Shelter Maintenance Services

Servicing for Accessible 

Portable Toilets, Hand 

Washing Units, etc.

Disposal of Bio-hazard 

Materials

FNSS Equipment

Durable Medical Equipment
117

Appendix 3

Durable Medical Supply Sample List

DME (for children and adults)

Equipment Quantity Type

3 in 1 Commode for over toilet use (300 lb capacity) 5 Each

Assorted utensil holder 8 Each

Accessible Cots 100 Each

Beds, bariatric, on wheels, up to 600 lbs 6 Each

Bedside Commodes (3ea-w/300 lb capacity; 2ea-w/450 lb capacity) 5 Each

Canes, quad (6ea-small base; 2ea-large base; 2ea-bariatric) 5 Each

Canes, white 3 Each

Comfort box (1ea knit pant, 1ea t-shirt, 1ea pair socks, hygiene items) 10 Box

Crutches, adult 3 Pair

Crutches, pediatric 3 Pair

Dressing aid sticks 5 Each

Handheld Shower w/84” hose 4 Each

Independent Toilet Seats w/safety bars 4 Each

IV Pole 5 Castor 3 Each

Patient Lift w/2 mesh slings (450 lb cap) (Hoyer lift) 2 Each

Privacy Screen, 3 panel w/castors 10 Each

Refrigerator, counter height, no freezer (for meds) 2 Each

Sheets, flat, fitted for bariatric bed (200 thread count or higher) 6 Each

Shower Chair w/back rest (4ea-400 lb capacity; 2ea-Bariatric) 6 Each

Egg Crate Padding -10 beds and 6 wheelchairs 10/6 Each

Walker, dual release (4ea-standard w/wheels; 2ea-heavy duty w/wheels;

2ea-bariatric w/out wheels; 2ea-standard w/out wheels) 10 Each

Medical Cot w/mattress & half side rails 4 Each

Wheelchair ramps, portable (1ea-10’; 1ea -6’) 2 Each

Wheelchair transfer boards 8 Each

Wheelchairs, adult (7ea-w/footrests; 3ea-w/elevating leg rest) 4 Each

Wheelchairs, adult, extra large (to 450 lb capacity; 1ea-w/footrest; 

1ea-w/elevating leg rest) 2 Each

Wheelchairs, pediatric (1ea-w/footrest; 1ea-w/leg rest) 2 Each
118

Appendix 4

Consumable Medical Supply Sample List

CMS (for children and adults)

Note 1: Planning estimate is based on 100 person shelter population for one week

Note 2: All liquid items must meet TSA standard (3.4 oz or less) in case of aerial evacuation

Item Description Quantity Notes

Antibacterial Wipes/ 

Towelettes 

40 pack 100

Bag, plastic 13 gallon 100

Nutritional Supplemental 

Drinks for Kids/Children 

(over 12 months of age), 

ready to drink (i.e.,Pedia-sure)

dispensed 

by medical 

authority in 

shelter

28-120 fl. oz. 

per day in no 

larger than 8 

oz bottles / 

196 - 658 per 

week

Magnifying Glasses 

(standard)

2

Paper Cup Lids for 12 oz cups 1 case

Bendable Drinking Straws 1 case

Duct Tape 12 rolls

Waterproofing Pads

(i.e. CHUX)

standard size 10 boxes of 

24

Patient Care Gloves,

non-latex

disposable 6 boxes 

Non-latex Cleaning Gloves disposable 4 boxes of 

100

Bio-hazard Bags for medical 

bio-waste

1 box of 24

Bleach, chlorine 2 gallons

Bucket, 2.5 gallon 10 each

Paper Towels 20 rolls

Hand Sanitizer 6 each large

Hand Sanitizer 100 each 

individual

Baggies (large/small) 10 boxes each

Instant Ice pkg of 12 Self-contained, break to use

Instant Heat pkg of 12 Self-contained, break to use
119

Emesis Basin (shallow) each 12 Plastic 8.5”

Bedpans each 2 disposable 

w/o cover

Resistant to stains and cracks. 350-pound 

weight capacity. Contoured design molded 

plastic for adults.

Bedpans each 10 disposable 

w/o cover

Resistant to stains and cracks. Dimensions: 

14” L x 11” W x 2.5”D. Weight capacity: 250 

pounds.

Urinals - male each 8 disposable 

w/cover

Plastic, disposable male urinal with cover - 

translucent 

Distilled Water (for 

humidifiers)

gallon 10

Nutrition drink for diabetics 

(i.e. Glucerna)

each 48 (8 oz 

bottles) 

Plastic bottle contains ingredients that 

contribute to blood glucose management and 

support cardiovascular health. For people 

with diabetes. For the use as a supplement, 

snack, or meal as a part of a diabetes 

management plan.

Nutrition Drink (i.e. Ensure) each 48 (8 oz. 

reclosable 

bottle) 

Source of concentrated calories and is high 

in protein to help patients gain or maintain 

healthy weight. It is a complete and balanced 

oral nutritional supplement that can be used 

with or between meals or, in appropriate 

amounts, as a meal replacement. 

Trach Care Tray each 2 W-Forceps. Sterile, single-use. Compact and 

disposable. All necessary components for 

care and cleaning of trach site. Tray includes 

removable basin, 2 latex-free gloves, trach 

brush, drape, 36” twill tape, 2 cotton tipped 

applicators, 2 pipe cleaners and 4 4”x4” 

gauze and plastic forceps. 

Scissors, blunt-end 2 each

Scissors, sharp and curved 2 each

Back Support each 2 Universal back support fits a range of sizes. 

Wide, elastic support base. Overlapping 

elastic compression panels. Adjustable and 

removable shoulder straps.

Cervical Collar, universal size each 4 Soft foam collar is slightly contoured 

for comfort. 1”-thick foam is covered 

with stockinet and has loop/lock closure. 

Universal style fits most. 2.5” wide at the 

chin, fits neck circumference 12-22”. 

Automatic Blood Pressure 

Cuff, adult with batteries, 

x-large

each 2 with x-large 

adult cuff

Displays simultaneous readings of systolic 

and diastolic blood pressure and pulse 

Automatic Blood Pressure 

Cuff, adult with batteries, 

standard

each 2 with 

standard cuff

Displays simultaneous readings of systolic 

and diastolic blood pressure and pulse 
120

Auto Blood Pressure Cuff, 

child, with batteries

each 2 with child 

cuff

Displays simultaneous readings of systolic 

and diastolic blood pressure and pulse 

Saline Solution (wound wash) each 12 A sterile saline solution (0.9%) for flushing 

and cleansing superficial wounds

Pill Crusher 6 each

Pill Cutter 6 each

Diapers, adult x-large 3 cases of 20

Diapers, adult large 3 cases of 20

Diapers, adult medium 3 cases of 20

Diapers, adult small 3 cases of 20

Pull-Up Adult Diapers small 1 cases of 20

Saniwipe Disinfectant Towels 2 pkgs Textured cloth for a rigorous disinfection 

in the most stringent medical environments 

and continuous exposure to bodily fluids and 

blood

Sterile Gauze Sponges 4”x4” 2 boxes of 

100

100 % cotton sponges of fine mesh gauze 

for wound debriding, prepping, packing, 

dressing, and general wound care

Sterile Gauze Sponges 2”x2” 2 boxes of 50 100 % cotton sponges of fine mesh gauze 

for wound debriding, prepping, packing, 

dressing, and general wound care

ABDs sterile wound 

gauze pads

(not the blue 

pads)

1 case

(approx 200)

ABD Pad Sterile 8”x10”. Soft, non-woven 

layer for patient comfort and fluff filler for 

absorbency. All four edges are sealed to 

prevent lint residue and leaking. Sterile, in 

single peel back sleeve. 

Ace Bandages (2”) rolls 2 boxes Economy Woven Elastic Bandage 2”x4.5yd. 

Clip Closure 1ea/bx 1ea/cs ETO Latex-free 

used for compression or securing of splints, 

dressings, and ice packs. Economy and 

standard REBs are standard grade woven 

bandages that offer balanced stretch and 

compression. 

Ace Bandages (3”) rolls 2 boxes Economy Woven Elastic Bandage 3”x4.5yd. 

Clip Closure 1ea/bx 1ea/cs ETO Latex Free 

used for compression or securing of splints, 

dressings, and ice packs. Economy and 

standard REBs are standard grade woven 

bandages that offer balanced stretch and 

compression. 

Ace Bandages (4”) rolls 2 boxes Economy Woven Elastic Bandage 4”x4.5yd. 

Clip Closure 1ea/bx 1ea/cs ETO Latex Free 

used for compression or securing of splints, 

dressings, and ice packs. Economy and 

standard REBs are standard grade woven 

bandages that offer balanced stretch and 

compression. 
121

Ace Bandages (6”) rolls 2 boxes Economy Woven Elastic Bandage 6”x4.5yd. 

Clip Closure 1ea/bx 1ea/cs ETO Latex Free 

used for compression or securing of splints, 

dressings, and ice packs. Economy and 

standard REBs are standard grade woven 

bandages that offer balanced stretch and 

compression. 

Application, cotton-tipped

(6” long, 100 per box)

2 boxes

Bandage Gauze Roll (2”) 6 dozen Cover-roll bandage 2”x10yd.

Bandage Gauze Roll (4”) 6 dozen Cover-roll bandage 4”x10yd.

Cotton Balls 4 bags of 50 100% cotton balls

Colostomy Appliance 2 packages Dependant on manufacturer

Colostomy Wafers 2 boxes of 10 Individually wrapped size 4”x4” wafer with 

flange (skin protector) 

Colostomy Paste 4 tubes (2 oz) IB Ostomy Paste 2 Oz Tube. Pectin based, 

skin barrier paste helps protect the skin 

around stomas and fistulas to prevent skin 

irritation and to fill-in uneven skin surfaces.

Colostomy Skin Preps 1 box of 50 

wipes

No-Sting Skin-prep Wipes. Forms protective 

film to prepare skin for tapes and adhesives.

Colostomy Ileostomy Bags 

(pouches)

11” drainable 

colostomy/

ileostomy bag 

(pouch)

1 boxes of 10 1 box of 10, cut to fit, drainable colostomy/

ileostomy pouch

TELFA Dressings, sterile 2 boxes Absorbent cotton pad. Superior “Ouchless” 

TELFA dressing won’t disrupt healing 

tissue by sticking to wound. Each dressing 

individually wrapped in peel-open envelope. 

Ideal as primary dressing for lightly 

draining wounds. Bonded on both sides with 

perforated non-adherent film; can be cut to 

any shape without separating. Sterile. Size: 

3”x4”.

General Antiseptic Cleansers 

(i.e., BZK Towelettes)

2 boxes of 

100

BZK Towelettes 5”x 7”. Used for general 

antiseptic cleansing for patients and 

staff, each towelette is saturated with 

benzalkonium chloride 1:750. Contains no 

alcohol. Latex-free.

Alcohol Prep Pads 4 boxes of 

100

100 pads per box

K-Y Jelly 4 tubes large

Peroxide 4 bottles 16 oz

Betadine Scrub Solution 4 bottles 16 oz

Adhesive, non-allergic

(1” paper tape)

6 each 1” x 11yds.
122

Adhesive, non-allergic

(2” paper tape)

6 each 2” x 11yds.

Safety Pins 1 box Nickel-plated steel. Each pin closed. Secure 

safety head. 1.75”. Box of 1440.

Medicine Cups 2 packages 

100

1 oz 

Hand Asepsis Towelettes 4 packages 

pk/160

antimicrobial hand wipe

Batteries – assorted 1 package 

each

AAA/AA/9 VOLT/C/D

Batteries - hearing aid 1 package 

each

assorted

Spray Bottle plastic 4 each 6 oz

Blood Glucose Meter Kit 4 Allows for alternate site testing and stores up 

to 300 test results. Includes meter, carrying 

case, lancing device, 10 lancets, control 

solution normal, alternate site testing cap. 

Test Strips, diabetic 2 boxes of 50 50 strips per box

Velcro, double sided

(loop and hook)

1”,2” and 4” 6 rolls

(2 or each)

2 rolls ea of 1”, 2”, and 4”x 50yds.

Nebulizer 2 FIO (2) settings adjustable from 35% to 

100%. It has ports for a feed set and an 

immersion-type heater. Capacity: ~350ml^.

 Isolation Mask 1 box of 50 Fluid-resistant, polypropylene outer facing 

with ear loops

Foley Catheter 10 each Cath Foley Sil 12Fr 5cc. An All Silicone 

Foley Catheter that is designed for enhanced 

comfort and elimination of concerns 

regarding potential health risks that may be 

associated with repeated exposure to latex 

devices.

Intermittent Catheter, male 25 each Cath Intmt Rdrbr 8Fr 16”. All-purpose, 

urethral, X-ray opaque with funnel end 

and round, hollow tip. Two opposing eyes. 

Sterile. Size A: 16”^. Size B: 8Fr^.

Condom Catheters, male 25 each Cath Exterior Tex Ltx 2-Pc W-Fm. With 

5.5”L x .75”W foam strap.

Intermittent Catheter, female 25each Intmt Pvc Pls Cath F 14 Fr 6.5”. Sterile. 

Clear polyvinyl chloride with matte finish, 

smooth rounded tip, funnel end. Size A: 

~6.5”^. Size B: ~14 Fr^.

External Catheter, male 25 each Cath Ext Tex Ltx 2-Pc W-Fm. With 5.5”L x 

.75”W foam strap.
123

Spray Adhesive, medical 5 cans Medical Adhesive Spray 3.2 oz. Increases 

the adhesion to skin for pouches, wound 

drainage collectors and fecal incontinence 

systems. 

Removal Wipes 1 box of 50 Universal adhesive remover for tapes, 

adhesives, and hydrocolloid skin barriers.

Leg Bags, assorted sizes

small/medium/large

500ml x 3 

600ml x 3 

950ml x 3 

9 (3 of each) T-Tap Leg Bag 500ml. Sterile. Secure, 

comfortable, soft vinyl bags, with flutter 

valve and Velcro strap. Latex-free. 

SizeA: ~500ml^. Style A:~With latex-free 

tubing and connector^. Sterility: Sterile^.

Cannulas Nasal Oxygen 

Tubes (disposable) 

5 each Nasal cannula, extra soft, curved tip, with

7 ft. (213 cm.) crush - resistant tubing.

Regulators, 02 2 Oxygen Regulator with overall length less 

than 4” and weighs just 6.9 oz. Lightweight 

aluminum body with brass sleeve and brass 

internals. Downward facing outlet port. 

Bedside Drainage Collectors 3 2000cc drainage bag with drip chamber, 

sample port and universal hanging device.

Power Strips 5 6 ft. length

Battery Chargers, universal 2 For recharging wheelchair batteries and other 

battery-powered equipment.

Extension Cords 3 50 ft. length

T.E.D. Compression 

Stockings 

1 each 

medium/

large/x-large

Support hose

Chemical-free Shampoo and 

Body Wash

2 (8 oz 

bottles)

Hypoallergenic cleanses - rinse free. 

Contains Aloe Vera Gel, no alcohol.

Chemical-free Spray Cleaner 2 (8 oz 

bottles)

Gentle cleanser contains Acemannan 

Hydrogel - No rinse, Non-irritating

Air Pump (bicycle type) 1 For wheelchair tires w/composite head 

fitting. Presta, Schrader, and Woods/Dunlop 

valves without switching internal parts. 
124
125

Appendix 5

Guidance for Providing Personal Assistance Services
126
Guidance on Planning 

for Personal Assistance 

Services in General 

Population Shelters

November 2010
128
129

Guidance on Planning for 

Personal Assistance Services 

in General Population 

Shelters

Goal

Present guidance to State, local, and tribal governments regarding the need to provide Personal 

Assistance Services (PAS) in general population shelters for children and adults with and without 

disabilities who have access and functional needs. 

Personal Assistance Services (PAS) are services that enable children and adults to maintain their usual 

level of independence in a general population shelter. 

Objectives

Present guidance on: 

• Defining “ sufficiency of services” 

• Minimizing risk and exposure to litigation 

• Identifying resources necessary to provide PAS to children and adults who require them 

• Planning considerations for assisting children and adults requiring PAS

• Utilizing volunteers and leveraging existing systems that provide PAS
130
Page Section

133 1. Acronyms

133 2. Purpose

133 3. Disclaimer

134 4. Scope

134 5. Premise

135 6. Definition

137 7. Legal Foundation for PAS Guidance

140 7.1. Legal Authorities and References

141 8. PAS Guidance

142 8.1. Introduction

142 8.2. Sufficiency of Care

142 8.3. Jurisdictional Variances

145 9. Providing PAS during an Emergency or Disaster

145 9.1. Leveraging Services

145 9.1.1. Identifying Existing Community Resources

147 9.1.2. Recruiting, Orienting, and Training PAS Providers 

148 9.1.3. Providing PAS Resources and Supplies

151 10. Glossary

152 11. Operational Tools

Contents

Guidance on Planning for Personal 

Assistance Services in General 

Population Shelters
132
133

Guidance on Planning for 

Personal Assistance Services

in General Population Shelters

1. Acronyms

AED Automated External Defibrillator

ADA Americans with Disabilities Act

CIL Center for Independent Living

CART Computer Assisted Real time Translations

CBO Community-Based Organization

CMS Consumable Medical Supplies

DME Durable Medical Equipment

EOC Emergency Operations Center

FEMA Federal Emergency Management Agency

FNSS Functional Needs Support Services

PAS Personal Assistance Services

TDD Telecommunications Device for the Deaf

TTY Teletypewriter

VOAD Voluntary Organizations Active in Disasters 

2. Purpose: 

The purpose of this document is to provide guidance to emergency managers and shelter planners 

for the development of Personal Assistance Services (PAS) for children and adults with and without 

disabilities who have access and functional needs and require PAS to maintain their usual level of 

independence in a general population shelter. These guidelines, based on Federal law directives, 

identify methods of achieving a lawful and equitable program. 

3. Disclaimer: 

This document provides guidance to assist emergency managers and shelter planners in understanding 

the requirements related to providing PAS to children and adults who require them in general 

population shelters. It is not intended to establish new legal obligations, alter existing obligations, or 

constitute a legal interpretation of the statutes that are the basis of the guidance materials. 

Listing of an agency’s or organization’s processes/procedures as an operational tool in this guidance 

does not constitute a recommendation or endorsement of the resource. In addition, information 

presented in an operational tool may have been summarized, modified, and/or combined with other 

cited sources.

This PAS Guidance is an appendix of the Guidance on Planning for Integration of Functional 

Needs Support Services in General Population Shelters and should be used in conjunction with that 

document. 
134

4. Scope: 

This document is intended to provide guidance regarding the PAS necessary to meet Federal 

requirements of integrating children and adults with and without disabilities who have access and 

functional needs into every aspect of emergency planning and response. It is intended to be used in 

conjunction with general population shelter standard operating procedures to ensure that all shelter 

residents benefit equally from programs, services, and activities. It provides a context for providing 

PAS in light of other existing plans and describes a process to use in any planning effort. These 

guidelines are scalable and can be applied to urban, suburban, and rural localities with multiple or 

limited resources. 

The PAS guidance recognizes that many jurisdictions across the country operate general population 

shelters and many have already developed emergency operations plans; however, the PAS Guidance 

is designed to help both novice and experienced emergency managers and shelter planners ensure 

inclusion of people with disabilities and/or access and functional needs.

Children and adults with and without disabilities who have access and functional needs and require 

PAS have the same right to services in general population shelters as other residents. Emergency 

managers and shelter planners have the responsibility to plan for shelter services and facilities that are 

accessible.

5. Premise: 

Every day, Americans provide extraordinary levels of assistance to individuals of all ages and 

situations. Formal and informal PAS are provided in virtually every community to enable children 

and adults with and without disabilities who have access and functional needs to maintain their 

independence and fully participate in all aspects of home and community life. 

Historically, gaps have existed in planning for and meeting the need for PAS in general population 

shelters. This has resulted in disparate treatment and the denial of full and equal services. This 

guidance is provided to ensure that children and adults with disabilities and/or access and functional 

needs are no longer turned away from general population shelters and inappropriately placed 

in special needs or medical shelters. Addressing these gaps benefits the entire community and 

maximizes resources.
135

6. Definition: 

Personal Assistance Services (PAS) are formal and informal services provided by paid personnel, 

personal attendants, friends, family members, and volunteers that enable children and adults to 

maintain their usual level of independence in a general population shelter. These services (when 

necessary) may include, but are not limited to, assisting with:

• Basic personal care:

◦ Grooming

◦ Eating

◦ Bathing

◦ Toileting

◦ Dressing and undressing

◦ Walking

◦ Transferring

◦ Maintaining health and safety

• Activities of daily living:

◦ Taking medications 

◦ Shopping for groceries 

◦ Communicating

◦ Accessing programs and services

The Operational Tools in this document are excerpts and examples taken from agency and 

jurisdictional documents throughout the United States. While they are not meant to dictate a State’s 

policies or procedures, they do present ideas and practices that can be adapted to fit each State’s 

specific needs.

Operational Tool #1 Personal Assistance Services

Definition 

of PAS

Personal Assistance Services – Also known as personal attendant services, attendant 

care services, and personal care services (PCS) – These services include “people or 

devices that assist a person with a physical, sensory, mental, or learning disability with 

tasks that the person would perform for himself or herself if he or she did not have a 

disability.” It includes a range of assistance provided to persons with disabilities and 

chronic conditions, which enables them to accomplish tasks that they would normally 

do for themselves if they did not have a disability.

PAS are provided to people of all ages to help with Activities of Daily Living (ADLs), 

such as grooming, eating, bathing, dressing and undressing, toileting, or Instrumental 

Activities of Daily Living (IADLs), such as taking medications, shopping for 

groceries, communicating, and accessing programs and services.

PAS are generally classified into two categories:

• Informal (unpaid) services provided by family members, friends, and 

neighbors 

• Formal services that are paid either directly out-of-pocket, or by public payers, 

private insurance, or other sources

Source Center for Personal Assistance Services, University of California, San Francisco, Cal.;

http://www.pascenter.org
136
137

7. Legal Foundation

For PAS Guidance

The Stafford Act and Post-Katrina Emergency Management Reform Act (PKEMRA), along with 

Federal civil rights laws, mandate integration and equal opportunity for people with disabilities in 

general population shelters. 

To comply with Federal law, those involved in emergency management and shelter planning should 

understand the concepts of accessibility and nondiscrimination and how they apply in emergencies. 

Following are key nondiscrimination concepts applicable under Federal laws, and examples of how 

these concepts apply to all phases of emergency management. 

1. Self-Determination – People with disabilities are the most knowledgeable about their own 

needs.

2. No “One-Size-Fits-All” – People with disabilities do not all require the same assistance and do 

not all have the same needs. 

• Different types of disabilities affect people in different ways. Preparations should be made 

for individuals with a variety of functional needs, including individuals who use mobility 

aids, require medication or portable medical equipment, use service animals, need 

information in alternate formats, or rely on a personal attendants.

3. Equal Opportunity – People with disabilities must have the same opportunities to benefit from 

emergency programs, services, and activities as people without disabilities.

• Emergency recovery services and programs should be designed to provide equivalent 

choices for people with disabilities as they do for individuals without disabilities. This 

includes choices relating to short-term housing or other short-term and long-term disaster 

support services.

4. Inclusion – People with disabilities have the right to participate in and receive the benefits of 

emergency programs, services, and activities provided by governments, private businesses, 

and nonprofit organizations. 

• Inclusion of people with various types of disabilities in planning, training, and evaluation 

of programs and services will ensure that all people are given appropriate consideration 

during emergencies.

5. Integration – Emergency programs, services, and activities typically must be provided in an 

integrated setting. 

• The provision of services such as sheltering, information intake for disaster services, and 

short-term housing in integrated settings keeps individuals connected to their support 

system and personal attendants and avoids the need for disparate service facilities.

6. Physical Access – Emergency programs, services, and activities must be provided at locations 

that all people can access, including people with disabilities.

• People with disabilities should be able to enter and use emergency facilities, and access the 

provided programs, services, and activities. Facilities typically required to be accessible 

include: parking, drop-off areas, entrances and exits, security screening areas, toilet rooms, 

bathing facilities, sleeping areas, dining facilities, areas where medical care or human 

services are provided, and paths of travel to and from and between these areas.
138

7. Equal Access – People with disabilities must be able to access and benefit from emergency 

programs, services, and activities equal to the general population.

• Equal access applies to emergency preparedness, notification of emergencies, evacuation, 

transportation, communication, shelter, distribution of supplies, food, first aid, medical 

care, housing, and application for and distribution of benefits. 

8. Effective Communication – People with disabilities must be given information that is 

comparable in content and detail to that given to the general public, as well as accessible, 

understandable, and timely.

• Auxiliary aids and services may be needed to ensure effective communication. These 

may include pen and paper or sign language interpreters through on-site or video and 

interpreting for individuals who are deaf, deaf-blind, hard of hearing, or have speech 

disabilities. Individuals who are blind, deaf-blind, have low vision, or have learning 

disabilities may need large print information or assistance with reading and filling out 

forms.

9. Program Modifications – People with disabilities must have equal access to emergency 

programs and services, which may entail modifications to rules, policies, practices, and 

procedures.

• Service staff may need to change the way questions are asked, provide reader assistance to 

complete forms, or provide assistance in a more accessible location.

10. No Charge – People with disabilities may not be charged to cover the costs of measures 

necessary to ensure equal access and nondiscriminatory treatment.

• Examples of accommodations provided without charge to the individual may include: 

ramps; cots modified to address disability-related needs; a visual alarm; grab bars; 

additional storage space for mobility aids and other equipment; lowered counters or 

shelves; Braille and raised letter signage; a sign language interpreter; a message board; 

assistance in completing forms and providing documents in Braille; large print or audio 

recording.

See FEMA’s Non-discrimination Principles of the Law:

http://www.fema.gov/oer/reference/principles.shtm

 

The Americans with Disabilities Act of 1990 (ADA), the Rehabilitation Act of 1973 (RA), and the 

Fair Housing Act (FHA), their regulations and agency guidance, as well as State counterparts, among 

others, define the scope of FNSS. These hallmarks of equal opportunity for people with disabilities 

include:

• The implementation and execution of a general policy of nondiscrimination on the basis of 

disability

• Sheltering persons with disabilities in the most integrated setting appropriate to the needs of 

the individual, which is the same setting people without disabilities enjoy in almost every case

• Reasonable modifications of policies, practices, and procedures to ensure nondiscrimination, 

with reasonableness judged in light of nondiscrimination principles applied in emergent 

circumstances

• The provision of auxiliary aids and services to ensure effective communication, with primary 

consideration of the aid or service given to the individual with a disability

• Elimination of eligibility criteria, discriminatory administrative methods, paternalistic safety 

requirements, and surcharges where discrimination results

• The selection of accessible sites for the location of general population emergency shelters, 

the construction of architecturally-compliant mass care shelters and elements, and required 

physical modifications to ensure program accessibility in existing facilities
139

The U.S. Department of Justice has provided guidance to State and local governments advising that 

people with disabilities should be housed in mass care shelters even if they are not accompanied 

by their personal care aides. “Some people with disabilities use personal care assistance for 

activities of daily living, such as eating, dressing, routine health care, and personal hygiene needs. 

One question that frequently arises is whether people with disabilities who use attendant care can be 

appropriately housed in mass care shelters. In most instances, they can. Most people with disabilities 

who use attendant care are not medically fragile and do not require the heightened level of medical 

care provided in a special needs or medical shelter. 

In the past, some shelter operators maintained policies that prevented people with disabilities who 

regularly use attendant care from entering mass care shelters unless they were accompanied by their 

own personal care attendants. These policies denied access to many people with disabilities. 

During emergencies, many personal care attendants – like other people – evacuate or shelter with 

their own families instead of staying with their clients. Shelter operators should provide support 

services in mass care shelters to accommodate people with disabilities who are not medically 

fragile but need some assistance with daily living activities unless doing so would impose an undue 

financial and administrative burden. Such assistance can be provided by medical personnel or trained 

volunteers.”1

 

1 http://www.ada.gov/pcatoolkit/chap7shelterprog.htm
140

7.1. Legal Authorities and References

ADA Best Practices Tool Kit for State and Local Governments, Chapter 7, Emergency Management 

under Title II of the ADA (2007), Addenda 1-3, and the Introduction to Appendices 1 and 2 (Attached 

as Exhibit 1); Titles II, III, and V of the Americans with Disabilities Act of 1990, 42 U.S.C. §§ 12101-

12103, 12131-12134, 12181-12188, and 12201-12213, as amended by the ADA Amendments Act 

of 2008. Nondiscrimination on the Basis of Disability in State and Local Government Services, 

28 C.F.R. pt. 35. Nondiscrimination on the Basis of Disability by Public Accommodations and in 

Commercial Facilities, 28 C.F.R. pt. 36. The Americans with Disabilities Act Title II Technical 

Assistance Manual (1993) and Supplement (1994). The Americans with Disabilities Act Title III 

Technical Assistance Manual (1993) and Supplement (1994). 

Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. §§ 794, as amended. Enforcement of 

Nondiscrimination on the Basis of Handicap in Programs or Activities Conducted by the Federal 

Emergency Management Agency, 44 C.F.R. pt. 16. Enforcement of Nondiscrimination on the Basis 

of Handicap in Programs or Activities Conducted by the Department of Justice, 28 C.F.R. pt. 39. 

Nondiscrimination on the Basis of Handicap in Programs or Activities Receiving Federal Financial 

Assistance, 45 C.F.R. pt. 84 (Department of Health and Human Services). Nondiscrimination on 

the Basis of Handicap in Programs or Activities Receiving Federal Financial Assistance, 34 C.F.R. 

pt. 104 (Department of Education). Nondiscrimination Based on Handicap in Federally Assisted 

Programs and Activities of the Department of Housing and Urban Development, 24 C.F.R. pt. 8.

Title VIII of the Civil Rights Act of 1968 (“Fair Housing Act”), as amended, 42 U.S.C. §§ 3601-3631. 

Discriminatory Conduct Under the Fair Housing Act, 24 C.F.R. pt. 100.

The Architectural Barriers Act of 1968, as amended, 42 U.S.C. §§ 4151-4157. Construction and 

Alteration of Public Buildings, 41 C.F.R. pt. 101-19.

The Homeland Security Act of 2002, 6 U.S.C. §§ 101-557, as amended.

The Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C. §§ 5121-5206, as 

amended. Federal Disaster Assistance, 44 C.F.R. pt. 206.

The Post-Katrina Emergency Management Reform Act, 6 U.S.C. § 761(d), as amended

Emergency managers and shelter planners are encouraged to investigate their applicable State laws 

for additional requirements. 
141

8. PAS Guidance

This document outlines common scenarios that general population shelter managers and operators 

may encounter during emergencies and disasters, and presents guidance to emergency managers 

and shelter planners on providing Personal Assistance Services (PAS) so people who require these 

services may benefit from the sheltering program. In most instances, PAS have not been provided in 

general population shelters up to this point. Clarification of legal obligations, recognition of the need 

to plan for all members of the community, and favorable outcomes resulting from implementation of 

best practices have all supported the benefits of planning for the delivery of PAS in general population 

shelters. The guidance provided in this document suggests strategies to assist in planning for PAS. 

PAS is provided in virtually every community on a daily basis. Consequently, resources to plan for 

shelter-based PAS are readily available locally. 

The Operational Tools in this document are excerpts and examples taken from agency and 

jurisdictional documents throughout the United States. While they are not meant to dictate a State’s 

policies or procedures, they do present ideas that can be adapted to fit each State’s specific needs.

Throughout this document “State” is used to refer to a U.S. State or U.S. territory.
142

8.1. Introduction

Historically, PAS for children and adults with disabilities have not been provided in general 

population shelters. During disasters, children and adults with and without disabilities who have 

access and functional needs have been re-directed to “special needs” or medical shelters. In some 

instances, the only shelters that would admit people with disabilities have been remotely located and 

have caused children and adults who required PAS to be separated from their families, friends, or 

personal attendants.

To help address the lack of PAS in general population shelters, this guidance has been developed to 

assist emergency managers and shelter planners in establishing plans to address the provision of PAS 

to children and adults who require these services in order to maintain their independence. 

Emergency managers and shelter planners need to include information in their State’s emergency 

response plan related to identifying, developing, and providing PAS in general population shelters.

8.2. Sufficiency of Care

General population shelters should be prepared to provide sufficiency of care for all residents. These 

services include PAS. As with other shelter services, it is imperative that plans to provide PAS are in 

place prior to an emergency or disaster.

Because PAS are offered in virtually every community, emergency managers and shelter planners can 

begin planning for these services at the local level by involving people who routinely use and provide 

these services. (Reference Leveraging Services below). In many instances, the individuals and/

or agencies that are experienced PAS providers will be willing and able to continue providing those 

services in a shelter setting. However, should these services be unavailable, the State should plan to 

use volunteers and/or paid providers to ensure a sufficiency of care when PAS is needed. 

8.3. Jurisdictional Variances

State codes and standards must, at a minimum, meet Federal requirements, but can be more 

comprehensive. The ADA and other Federal laws, including the Stafford Act, the Rehabilitation 

Act, the Fair Housing Act, and the Architectural Barriers Act, provide affirmative obligations 

and prohibitions of discrimination on the basis of disability. No State or local government, or its 

contractors, in providing services may, by law, policy or contract, provide services below those 

standards without violating Federal law. This does not mean that a State or local government cannot 

enact laws and ordinances or provide services, obligations, and prohibitions that extend beyond these 

standards to ensure even greater access. A common example would be to provide twice as many as 

the required number of accessible parking spaces and access aisles.
143

Because each jurisdiction (State, local, and tribal) is different and the laws, rules, and regulations that 

apply to each State and community vary, there is no single national plan for providing PAS in general 

population shelters. Emergency managers and shelter planners should use existing information 

regarding the local laws, rules, regulations, and demographics of their State and/or community to 

develop a plan to provide PAS. At a minimum, the plan should consider and address:

• Existing information regarding the day-to-day utilization of PAS 

• Service provider-to-shelter resident ratios based on projected need for PAS and availability of 

State and local resources to provide these services in a shelter setting

• The development of plans and agreements to utilize resources (e.g., DME and CMS) currently 

available to provide required PAS

• Potential gaps in current information regarding the need for PAS, including:

◦ Transient populations such as migrant workers and tourists 

◦ Individuals who receive informal PAS from family and friends

◦ Plans for providing PAS in regional evacuation areas where local PAS resources may be 

insufficient, destroyed, or damaged 

Emergency managers and shelter planners need to include in their State plan, options for providing 

PAS outside the area where an emergency or disaster occurs in the event that it is not possible to 

shelter residents in their home community. 

Operational Tool #2 Demographic Information – by State

Sample of available information 

regarding the number of persons 

who have a disability or have 

difficulty performing self-care 

activities in California

1,109,000 persons (3.9%) of Californians have difficulty with 

self-care activities and/or other routine activities

Source Center for Personal Assistance Services, University of 

California, San Francisco, Cal; http://www.pascenter.org

Note: Click on Need for PAS; click on Disability Statistics 

Operational Tool #3 Demographic Information – by county

Sample of available 

information regarding the 

number of persons who have 

a disability or have difficulty 

performing self-care activities 

in Travis County, Texas

1.3% of the population ages 16 through 64 have a “self-care 

disability” and 2.2% have a “go outside disability.” 12% of the 

population, ages 65 and above, have a “self-care disability” and 

18.9% have a “go outside” disability.” These percentages in either 

category should not be added together since people with a “selfcare disability” are often a subset of the “go outside disability.”

Source Center for Personal Assistance Services, University of California, 

San Francisco, Cal.; http://www.pascenter.org

Note: Click on Need for PAS; click on Disability Statistics; 

click on Disability Statistics; click on Disability Prevalence for 

Counties; click on Texas; click on Travis County
144
145

9. Providing PAS During an 

Emergency or Disaster

9.1. Leveraging Services

9.1.1. Identifying Existing Community Resources

Long before an emergency or disaster occurs, emergency managers and shelter planners should begin 

working closely with individuals in the community who require PAS. Emergency managers and 

shelter planners should also reach out to organizations and providers that routinely provide PAS to 

children and adults with disabilities. It is essential that appropriate PAS are available when needed in 

an emergency situation. Suggested Community-based Organizations (CBO) providing or advising on 

PAS on a regular basis include, but are not limited to:

• Center for Independent Living (CIL)

• Home health organizations

• Rehabilitation centers

• Home and community living organizations

• Respite providers

• Mental health organizations

• Developmental disability organizations

• Aging organizations

• Advocacy groups

• Protection and advocacy agencies

• The Salvation Army

• Faith-based organizations

• Colleges and universities

• Vocational service agencies

• Rehabilitation agencies

• American Red Cross

• Personnel from nursing homes and assisted living facilities

• Personnel from hospitals and health care systems
146

Operational Tool #4 Identifying PAS Resources

Locating PAS Assistance and advice on providing PAS is available from: 

• The National Council on Independent Living

• Association of Programs for Rural Independent Living 

• Independent Living Research Utilization

Source http://www.ncil.org

1710 Rhode Island Avenue Northwest/Fifth Floor

Washington, D.C. 20036 

Source http://www.april-rural.org

Source http://ilru.org/

Operational Tool #5 Identifying Community-based PAS

Involvement and 

cooperation with local 

community-based 

organizations (CBOs)

• Identify and build relations with the CBOs already linked to local 

government through service contracts

• Meet to discuss potential areas for CBOs involvement in care and 

shelter operations

• Encourage CBOs to cooperatively use their resources (e.g., food, 

transportation, health/mental health services) to ensure that care and 

shelter services meet the PAS needs within the community

• Determine the support that CBOs will need to keep services going 

during a disaster or emergency

• Focus additional meetings around specific planning issues 

• Involve CBOs in disaster planning, training, and exercises sponsored 

by State and local governments

• Support CBOs by:

◦ Giving them priority status for supplies or resources

◦ Having a CBO representative in the EOC

◦ Establishing a memorandum of understanding with selected CBOs 

◦ Developing agreements with CBOs stipulating that the CBOs will 

make staff experienced in providing PAS as required during an 

emergency or disaster 

Source A Guide for Local Jurisdictions In Care and Shelter Planning, Alameda 

County Operational Area Emergency Management Organization, 

September 2003

http://www.cdsscounties.ca.gov/coplanners/res/pdf/doc16.pdf
147

9.1.2. Recruiting, Orienting, and Training PAS Providers

Emergency managers and shelter planners should include in their plans strategies to recruit, enroll, 

orient, and communicate with PAS providers. 

Recruitment strategies can include:

• Utilizing existing PAS providers

• Publicizing the need for PAS providers in malls, universities, service club newsletters, State 

and local websites, and public services announcements

• Targeting individuals with interests and/or skills to provide PAS

• Implementing a simple process for volunteering 

Enrollment strategies can include:

• Obtaining basic identifying information on providers

• Completing criminal background checks, when necessary 

Orientation strategies can include:

• Defining PAS

• Stating what tasks PAS providers will be expected to perform

• Providing comprehensive information about how to:

◦ Set-up exercises for PAS providers to practice the tasks they will be expected to perform 

◦ Develop a training curriculum that includes how to provide assistance in:

▪ Basic personal care

Grooming

Eating

Bathing

Toileting

Dressing and undressing

Walking 

Transferring

Medications, DME, and CMS

Maintaining health and safety

▪ Effective communication

▪ Accessing programs and services

Operational Tool #6 PAS Workers and Personal Attendants 

PAS Workforce Project Presents information regarding PAS workers and personal attendants, 

including who they are, what they provide, and tools and support 

necessary to carry out their tasks

Source Center for Personal Assistance Services; http://pascenter.org

Note: Click on Workers and Caregivers

Implementing these or similar strategies will increase the likelihood that PAS providers will be 

available when they are needed and that they will be assigned appropriate PAS responsibilities during 

an emergency or disaster. 

 
148

Operational Tool #7 Non-professionals Providing PAS

Red Cross Family 

Caregiving 

Includes information for non-professionals who are providing PAS including:

• Home safety

• Caregiving Skills

• Body Mechanics

• Personal Care

• Healthy Eating

• Caring for the Caregiver

• Legal and Financial

• Dementia

• Caregiving Resources 

Source Be Red Cross Ready, American National Red Cross, Safety Series Vol.1, 

2007; www.mississippi-redcross.org

Operational Tool #8 PAS Training

Providing information, 

training, and experience 

to persons providing PAS

Prior to an emergency, plan how staff will be instructed in their roles 

and responsibilities during a disaster. Include in the training:

• A definition of “emergency”

• When an emergency plan will be implemented

• Roles and responsibilities of essential and non-essential PAS 

providers

• Procedures for educating clients about the preparedness plan

• Information for PAS providers regarding how they can work 

with the local shelter management during an emergency 

Source Virginia Department of Health, Office of Licensure and Certification, 

Emergency Preparedness Planning for Hospice and Home Care 

Providers, Effective September 1, 2006

http://www.vdh.state.va.us/OLC/Laws/documents/HCO%20and%20

HSP%20emergency%20prep.pdf

9.1.3. Providing PAS Resources and Supplies

In addition to identifying staff and volunteers to provide PAS, emergency managers and shelter 

planners should include in emergency plans, several options for pre-identifying resources and supplies 

that will be critical to assisting children and adults who require PAS. This includes DME, CMS, and 

the services that support the provision of PAS. At a minimum, plans should address: 

• Processes for locating, purchasing, and storing as much of the DME and CMS as possible and 

practical to meet the needs of children and adults who require PAS

• Agreements with providers to ensure that necessary DME and CMS will be available during 

an emergency or disaster

• Agreements with communities to ensure that if one community is severely damaged or 

destroyed, necessary DME and CMS will be available

• Identifying and leveraging resources of assistive technology exchanges, lending, and 

reutilization programs
149

Operational Tool #9 Durable Medical Equipment (DME) List

DME (for children 

and adults)

See the “Guidance on Planning for Integration of Functional Needs Support 

Services in General Population Shelters” for the Federally-approved DME 

list.

Source FEMA: Guidance on Planning for Integration of Functional Needs Support 

Services in General Population Shelters; Appendix 3: Durable Medical 

Supply Sample List

Operational Tool #10 Consumable Medical Supplies (CMS) List 

CMS (for children 

and adults)

See the “Guidance on Planning for Integration of Functional Needs Support 

Services in General Population Shelters” for the Federally-approved CMS 

list.

Source FEMA: Guidance on Planning for Integration of Functional Needs Support 

Services in General Population Shelter; Appendix 4: Consumable Medical 

Supply Sample List

Operational Tool #11 Communication Devices

Communication 

Devices – not 

inclusive

• Sound amplification aids: TTY/TDD Phones

• Computer/laptop with capability for video relay communication

• Cap Tel Phones (for captioning)

• Computer Assisted Real-time Translation

• Hearing aid batteries of different sizes (including batteries for cochlear 

implants)

Source Guidance on Planning and Responding to the Needs of People with Access 

and Functional Needs, California Emergency Management Agency, Office for 

Access and Functional Needs; http://www.calema.ca.gov/ 

Note: Click on Office for Access and Functional Needs

Source BCFS: www.bcfs.net/fnssrecommendations

Operational Tool #12 Resource for Assistive Technology 

Reuse of assistive 

technology

There is at least one Federally funded program in every State that engages 

in the reuse of assistive technology. These programs are also connected to 

other entities in the State that reuse assistive technology so they can serve as 

a central point of contact for emergency managers and shelter planners. 

Source http://www.resnaprojects.org/nattap/at/statecontacts.html

(contact information only)

Source http://www.resnaprojects.org/nattap/at/statecontacts.html#al

(contact information)

In addition to DME, CMS, and communication devices, emergency managers and shelter planners 

should ensure that the services necessary to support the provision of PAS are identified and 

consistently available. 
150

Operational Tool #13 Legal Authority for PAS

Legal Authority 

for PAS

Federal agencies may, on the direction of the president, provide assistance 

essential to meeting immediate threats to life and property resulting from a major 

disaster, including:

• Medicine, durable medical equipment, goods, and other consumables

• Emergency medical care; emergency mass care shelter; and provision of 

food, water, medicine, and durable medical equipment 

In any emergency, the president may assist State and local governments in the 

distribution of medicine, food, and other consumable supplies and emergency 

assistance.

Federal authority for provision of PAS can be found in the reference below. 

Source Source Sections 403 (a)(2) and (3)(B) and 502(a)(7) of the Robert T. Stafford 

Disaster Relief and Emergency Assistance Act, 42 U.S.C. §§ 5121-5206, as 

amended. Federal Disaster Assistance, 44 C.F.R. pt. 206.

http://www.fema.gov/about/stafact.shtm

During an emergency or disaster, some shelters may have no source of emergency power generation, 

while others may have only a limited source. Emergency managers and shelter planners should take 

whatever steps are necessary to plan for providing an alternate source of power in the event of an 

outage.

Many children and adults who require PAS depend on battery-powered assistive devices for mobility, 

including wheelchairs and scooters. The batteries in these mobility aids must frequently be recharged 

or they stop functioning. Without these mobility aids, children and adults with disabilities lose their 

ability to move independently. This may render them unable to participate in some services offered by 

the shelter and more dependent on assistance from others.

In addition, plans should include arrangements with multiple providers for an ongoing supply of 

oxygen and access to dialysis facilities. Not having these services available will result in a failure to 

provide residents sufficient care and may result in an unnecessary surge on medical facilities. Many 

people live independently and require very little assistance when they are able to access oxygen, 

dialysis, and other life sustaining aids and services. 

Emergency managers and shelter planners should make arrangements for these services well before 

an emergency or disaster, and should include back-up plans in the event that primary providers cannot 

follow through as promised. DME and CMS may be available from a State, regional, FEMA, and/or 

HHS stockpile. 

When a shelter does not have in place the provisions for necessary DME, CMS, and communication 

devices and services, operating a general population shelter that includes children and adults requiring 

PAS becomes much more difficult and seriously threatens the well being of shelter residents. 

Every community will have residents and visitors needing PAS in a disaster. Planning to meet these 

needs in advance strengthens the ability of the community to meet the needs of its members and 

maximize limited resources. 
151

10. Glossary

Cap Tel

A communication system that provides written captions of everything a caller says on a built-in 

display.

CART

Computer Assisted Real-time Translation

Consumable Medical Supplies (CMS)

Medical supplies (medications, diapers, bandages, etc.) that are ingested, injected, or applied and/

or are one time use only 

Durable Medical Equipment (DME)

Medical equipment (e.g., walkers, canes, wheelchairs) used by persons with a disability to 

maintain their usual level of independence

Sufficiency of care

The services that shelter residents, including children and adults with disabilities and/or access or 

functional needs, require in order to maintain a pre-disaster level of health and independence

TDD

Telecommunications Device for the Deaf

TTY

Teletypewriter

Universal/Accessible Cot 

A Universal/Accessible cot that meets the following recommended criteria: 

• Height 17”-19” without [below] the mattress(es)

• Width – minimum 27” 

• Weight capacity – 350+ pounds 

• Flexible head and feet position 

• Rails, if any, must be positioned or moveable in such a way as to allow for wheelchair 

access. No IV pole. 
152

11. Operational Tools*

Operational Tool #1 Personal Assistance Services

Operational Tool #2 Demographic Information – by State

Operational Tool #3 Demographic Information – by county 

Operational Tool #4 Identifying PAS Resources

Operational Tool #5 Identifying Community-based PAS

Operational Tool #6 PAS Workers and Personal Attendants

Operational Tool #7 Non-professionals Providing PAS

Operational Tool #8 PAS Training

Operational Tool #9 Durable Medical Equipment (DME) List

Operational Tool #10 Consumable Medical Supplies (CMS) List

Operational Tool #11 Communication Devices

Operational Tool #12 Resource for Assistive Technology

Operational Tool #13 Legal Authority for PAS 

* Operational Tools – The Operation Tools in this document are excerpts and examples taken from 

agency and jurisdictional documents throughout the United States. While they are not meant to 

dictate a State’s policies or procedures, they do present ideas and practices that can be adapted to fit 

each State’s specific needs.
153
154
155

Appendix 6

One Day Menu for General Population Shelters Providing 

Functional Needs Support Services

ONE DAY MENU

One day 

menu

Regular Diabetic Reduced Sodium Pureed Infant

Breakfast Orange Juice 6 oz

Grits

Scrambled Egg

Bacon

Biscuit/Margarine

Coffee or Tea

Milk skim or 2% 8oz

Orange juice 6 oz

Grits

Scrambled Egg

Bacon

Biscuit/Margarine

Coffee or Tea

Milk skim 8oz

Orange Juice 6 oz

Grits

Scrambled Egg – no 

salt when cooking

Biscuit/Margarine

Coffee or Tea

Milk skim 8oz 

Orange juice 6 oz

Grits

Scrambled Egg 

pureed

Biscuit/Margarine 

pureed

Coffee or Tea

Milk skim 8oz

Formula 

and baby 

food

Lunch Hamburger on bun

Potato chips

Peaches in juice

Cookie

Ketchup/Mustard

Coffee or Tea

Milk skim or 2% 8 oz

Hamburger on bun

Potato chips

Peaches in Juice

Sugar free cookie

Ketchup/Mustard

Coffee or Tea

Milk skim 8 oz

Hamburger (no salt 

when cooking) on 

bun

Potato chips

Peaches in juice

Cookie

Ketchup

Coffee or Tea

Milk skim 8 oz

Hamburger on bun 

pureed

Mashed potatoes

Peaches in juice 

pureed

Cookie pureed

Ketchup/Mustard

Coffee or Tea

Milk skim 8 oz

Formula 

and baby 

food

Dinner Turkey and Gravy

Dressing

Carrots

Pears in juice

Bread 2 slices

Margarine

Coffee or Tea

Milk skim or 2% 8 oz

Turkey and Gravy

Dressing

Carrots

Pears in juice

Bread 2 slices

Margarine

Coffee or Tea

Milk skim 8 oz

Turkey and low 

sodium gravy

Dressing

Carrots

Pears in juice

Bread 2 slices

Margarine

Coffee or Tea

Milk skim 8 oz

Turkey and gravy 

pureed

Dressing pureed

Carrots pureed

Pears in juice pureed

Bread 2 slices 

Margarine

Coffee or Tea

Milk skim 8 oz

Formula 

and baby 

food

Source BCFS; www.bcfs.net/fnssrecommendations 
156

Appendix 7

FORM: Resident Health Care Information
RESIDENT’S HEALTH CARE RECORD

Name of Resident:

Assigned Resident #: DOB: Sex:Date Time Complaint Treatment

© 2010 BCFS
158

Appendix 8

FORM: Medication Administration Record
MEDICATION ADMINISTRATION RECORD

Name of Guest:

Shelter: DOB:

Allergies:

Date Time Medication Dosage Route Nurse’s 

Initials

Printed Nurse’s Name: Initials 

Printed Nurse’s Name: Initials 

Printed Nurse’s Name: Initials 

© 2010 BCFS
160

Appendix 9

FORM: Transportation Request Information
TRANSPORTATION REQUEST FORM

Date request: Time:

Name of Requester:

Name of Resident needing transportation:

Assigned Resident #:

Additional Family Members to be Transported:

Address of Pick Up Location:

Purpose of the Trip: Medical Need Return Home Other

Name of Destination:

Contact at the Discharge Destination: 

Contact Phone Number:

Any special equipment or transportation (wheelchair van, stretcher, etc.) needed for persons listed above:

Luggage to be transported if at discharge:

Date and Time for pick up:

Date and Time for return to shelter if applicable: 

Transportation arranged: Yes No

If no, explain: 

Requester Notified of Action on Request: Yes No

Date and Time of Notification:

Notified by Whom:

© 2010 BCFS
162

Appendix 10

FORM: Resident Discharge Information
DISCHARGE FORM

Staff Information

Shelter Name: Date:

Name of Person Filling out Form: 

Personal Information

Last Name: First Name: 

Resident ID: Address:

Phone No: 

Caregiver Name (if applicable): 

Relationship: Phone No: 

Number of Individuals discharged with guest:

List Individuals discharged with guest:

Name Resident ID Relationship

Destination

□ Home □ Nursing facility □ Hospital □ Hotel

□ Apartment □ Friend □ Family □ Caregiver

□ Shelter □ Retirement Facility □ Hospice

Other:

Name of Destination Facility:

Address: Phone No:

Email: Fax No:

Alternate Point of Contact: (Name & Phone #): 

PLEASE CONTINUE FILLING OUT THE FORM ON THE BACK

© 2010 BCFS
Transportation Needs

□ Car □ Bus □ Accessible Vehicle □ Ambulance

Other:

Discharge Checklist

□ Electricity to area

□ Guest is physically able to make the trip

□ Roads clear to destination

Equipment and Supplies Returned with Guest:

□ Medication □ Equipment □ Personal Items

Medication/ Equipment:

Forwarding Address of Resident:

Additional Comments:

GUEST SIGNATURE: 

DATE: TIME:

© 2010 BCFS