Core Function Five: Evacuation

Identify scenarios or conditions that could occur and that would require an evacuation (including an evacuation of only some of your residents, individuals, or clients).

Ensure that your disaster plan considers the following topics.

Destination Sites and Alternate Destination Sites

Identify the destination sites and alternate destination sites of an evacuation. Choose sites that will not be affected by the disaster that affects your facility.

Ensure that the sites can help you meet the needs of your facility's evacuees. Consider questions such as:

  1. Does your facility have residents, individuals, or clients who receive critical care?
  2. How this information is kept current in the disaster plan?
  3. Do they have pre-determined destinations (for example, a nursing home that has a ventilator or oxygen, a hospital, etc.)?
  4. Have you used the FIVES system (see the preceding page)?

If your nursing home is evacuating pediatric residents, the destination site must meet the TAC requirements for such residents.

HCSSAs, nursing facilities, and assisted living facilities can help their clients register with the 211 system. For more information, see Provider Letter #06-25.


With the exception of a freestanding hospice inpatient unit, DADS does not require an agency to physically evacuate or transport a client.

Agency personnel that must be involved with developing, maintaining, and implementing an agency's emergency preparedness and response plan include:

  1. the administrator;
  2. the supervising nurse, if the agency is required to employ or contract with a supervising nurse as required by §97.243 of this subchapter (relating to Administrative and Supervisory Responsibilities);
  3. the agency disaster coordinator; and
  4. the alternate disaster coordinator.

An agency must provide and discuss the following information about emergency preparedness with each client:

  1. the actions and responsibilities of agency staff during and immediately following an emergency;
  2. the client's responsibilities in the agency's emergency preparedness and response plan;
  3. materials that describe survival tips and plans for evacuation and sheltering in place; and
  4. a list of community disaster resources that may assist a client during a disaster, including the Transportation Assistance Registry available through 2-1-1 Texas, and other community disaster resources provided by local, state, and federal emergency management agencies. An agency's list of community disaster resources must include information on how to contact the resources directly or instructions to call 2-1-1 for more information about community disaster resources.

(When contacting the client or person(s) responsible for a client's emergency response plan review the client's supply of adequate amounts of food, water, medications, and critical supplies and equipment for an emergency.)

The agency's emergency preparedness and response plan must include procedures to identify a client who may need evacuation assistance from local or state jurisdictions because the client:

  1. cannot provide or arrange for his or her transportation; or
  2. has special health care needs requiring special transportation assistance. If the agency identifies a client who may need evacuation assistance, agency personnel must provide the client with the amount of assistance the client requests to complete the registration process for evacuation assistance if the client:
    • wants to register with the Transportation Assistance Registry, accessed by dialing 2-1-1; and
    • is not already registered, as reported by the client or legally authorized representative.

An agency is not required to continue to provide care to clients in emergency situations that are beyond the agency's control and that make it impossible to provide services, such as when roads are impassable or when a client relocates to a place unknown to the agency. An agency may establish links to local emergency operations centers to determine a mechanism by which to approach specific areas within a disaster area in order for the agency to reach its clients.

All HCSSA must comply with 40 TAC 97.256 relating to an agency's written emergency preparedness plan and implementation.

HCSSAs with an inpatient unit must also comply with 40 TAC 97.403(w) (2).

Written and Signed Agreements

Ensure that you have a written, signed, and current (not more than one-year-old) agreement with each site that will receive your residents, individuals, or clients. Examples of such agreements include: an exchange of letters in which each party commits to providing assistance to the other during disasters, a written Memorandum of Understanding, a mutual aid agreement, etc. Attach a copy of each agreement to your disaster plan.

Consider questions such as:

  1. What process will ensure that the destination sites remain available at the time of the evacuation?
  2. What process will notify the people in these sites that a decision has been made to evacuate to their sites?
  3. What supplies will the destination sites provide?
  4. How long can your facility's evacuees stay at the sites?

Distance and Routes

The distance that evacuees have to travel can vary. Sometimes a destination site might be only a few miles away. A hurricane, however, might require a site that is hundreds of miles away and an evacuation that takes more than a day.

Consider questions such as:

  1. How far away is each destination site?
  2. What route will you use to reach each site? Include a map of these routes.
  3. What are the alternate routes? Include a map of these routes.
  4. Do you have written driving directions for the drivers?
  5. How will you know the condition of roads and highways that you plan to use during an evacuation?
  6. Are there any hospitals on or near the evacuation routes?

Highway condition information for all roads on the state highway system in Texas is at:

Preparing to Leave the Facility

Consider questions such as:

  1. How will you ensure that staff members accompany your residents, individuals, or clients during an evacuation?
  2. What procedure will verify that all residents, individuals, or clients have been evacuated? (Note: Do not search for people in a fire-involved building. Instead inform firefighters that people are missing.)
  3. How will you account for residents, individuals, or clients who are out on pass during an evacuation?
  4. How will you evacuate the pets of your residents, individuals, or clients? (Some evacuation sites might not accept pets).
  5. Who will continue or shut down operations while an evacuation is underway? (They must be able to recognize when to abandon the operation and evacuate themselves.)
  6. Are there residents who have relatives or caretakers who have agreed to pick them up?

Notifying Emergency Contacts and Others of Evacuations

Consider questions such as:

  1. Who will notify the residents' families or emergency contacts of an evacuation and of the destination?
  2. Who will track completion of the notifications
  3. What other government agencies will be notified of an evacuation?

After Leaving the Facility

Ensure that your disaster plan considers the following topics.

En Route

Consider questions such as:

  1. Who will track the location of your facility's evacuees?
  2. If you have several vehicles traveling together, how will the vehicles avoid getting separated?
  3. How will staff stay in contact with each other during an evacuation?
  4. Who will feed and clean your facility's evacuees while en route?
  5. Who will administer medications?

Your evacuation should provide for stops and layovers so that staff can attend to the needs of the evacuees.

Arrival at the Destination

Consider questions such as:

  1. Who will notify the evacuees' families or emergency contacts that the evacuees have arrived at their destination?
  2. Who will track completion of the notifications?

Return to the Facility

Consider questions such as:

  1. Who will remain in contact with officials to determine when the evacuees can return to their facility?
  2. What process will determine when the facility is able to return to function, structural or otherwise? (For example, do staff return first to the facility to assess damage and see if a return is possible?)
  3. Who gives the "okay to return" signal?
  4. How will you ensure the return of the evacuees to their facility after the disaster?
  5. What is the process to accept the evacuees back into the facility?