State Policies Concerning Disaster Preparedness for Home- and Community-Based Service Providers.

Older adults are among those most vulnerable to harm in disasters, such as hurricanes and wildfires. Nursing homes and other Medicare providers are subject to federal requirements to develop detailed disaster plans. However, millions of older adults receive care at home from non-Medicare providers who are under federal disaster preparedness rules that are less prescriptive than Medicare rules and subject to state interpretation. This study assessed the disaster preparedness policies for Older Americans Act-funded home- and community-based programs in 10 states with high numbers of older adults and experience with disasters. We found considerable variation by state. The results raise questions about the protection provided to vulnerable individuals who receive care at home in some states. However, the policies of some other states indicate an awareness that government has a significant role in protecting older adults exposed to disasters and that disaster preparedness is a component of aging in place.