Skip to main content
Rural Health Information Hub

Rural Community Response to an Emergency or Disaster

Following a disaster, rural communities should closely follow the procedures and actions determined during the planning phase and outlined in the all-hazards response plan. Following a specific established plan will ensure that the response begins locally and follows a tiered response, efforts are scaled and flexible to meet evolving demands, and partners are united and ready to act. These are guiding principles for emergency response identified by FEMA.

Some of the key components and considerations related to rural community response are:

  • Initiate a response
  • Engage partners and define responsibilities
  • Leverage existing infrastructure
  • Use evidence-based interventions and stages
  • Deliver open and inclusive communication
  • Begin actions to enable recovery

Initiate a Response

It is important to initiate a response immediately after a disaster or emergency occurs. Rural communities may implement different activities in the response phase, depending on the type of disaster or emergency. For more information on disaster types, see Module 4: Types of Public Health Emergencies and Disasters.

The activities implemented for a response should focus on reducing or minimizing threats to health, safety, security, and the economy. Examples of these activities include:

  • Conducting preliminary needs assessments – Local communities may conduct a needs assessment to determine immediate needs, such as search and rescue or other critical assistance. Assessing needs at the start helps decision-makers prioritize resources to address the most pressing health, medical, and public safety needs first.
  • Activating emergency operations – Local communities activate and oversee the local incident management activities. Initiating the command structure allows for immediate coordination and response. State Emergency Operations Centers (SEOCs) may also be activated to support a local response and coordinate additional assistance from state or federal government.
  • Developing and maintaining incidence response strategy – Continue to coordinate and deliver activities that stabilize the community's health and medical needs and support morale. This includes focusing efforts to maintain or restore the services that are most critical to the affected population.
  • Communicating with partners and the population – Deliver critical messages that are culturally and linguistically appropriate for the affected population. Ongoing communication with partners is also crucial to ensuring resources are available when needed.

The National Incident Management System (NIMS) provides a standardized and common approach for initiating a response and managing an incident. Organizations and communities using the NIMS as a framework can ensure coordination of response partners, including firefighters, public works, police, and EMS, to directly address the needs of the community, while leaders work with government agencies and other partners to coordinate aid and other strategies.

The goal of the response phase is to meet the basic needs of the community, including shelter, food and water, medical care, initial repairs to aid the response process, and other types of immediate assistance.

Presidential Disaster Declaration

Disaster declarations initiate multiple federal programs to assist a community in response and recovery operations. According to the Stafford Act, disaster declarations are the sole discretion of the President. For the President to declare a major disaster, the Governor of the affected state or leadership of eligible territories must submit a declaration request. The Sandy Recovery Improvement Act expanded the request process so tribal governments may also submit disaster requests. Requests are submitted through the appropriate FEMA regional office.

There are two types of declarations that the President can make: emergency declarations and major disaster declarations. Each type has different requirements and resources available. Emergency declarations provide supplemental assistance for emergency service operations up to $5 million. State and tribal governments may submit a request before an emergency strikes, in anticipation of disaster impact that would surpass the state's capacity to respond. Major disaster declarations are for any natural event and include a wide range of federal assistance for both emergency operations and permanent works.

To obtain a disaster declaration, local community leaders must communicate with their Governor and leverage partnerships with the state government. They must also complete a preliminary damage assessment.

For more information on conducting damage assessments, see Assess Impact and Damage Post-Emergency.

For more information on requesting assistance, see How to Request Assistance for Emergency Preparedness and Response.

Engage Partners and Define Responsibilities

A successful response relies on coordination and cooperation of partners and collaborators across jurisdictions, sectors, and levels of government. The all-hazards plan should articulate the responsibilities of each partner and ensure a clear line of operational management for emergency incidents. This ensures that all response efforts and partner activities are unified to achieve a common goal.

Case Study

Critical Access Hospital in Estes Park, Colorado, Evacuates Due to a Wildfire
The 2020 wildfires in Estes Park, Colorado, highlighted the importance of a preparedness plan that defines roles and responsibilities for partners. During this response, multiple partnerships with private and public sector contractors as well as government agencies, such as the school district, contributed to the success of the Critical Access Hospital's emergency evacuation.

Engaging partners and using a Whole Community approach to response are important for risk management. The Department of Homeland Security (DHS) defines risk management as the “process of identifying, analyzing, assessing, and communicating risk and accepting, avoiding, transferring or controlling it to an acceptable level considering associated costs and benefits of any actions taken,” where risk is “potential for an unwanted outcome resulting from an incident, event, or occurrence, as determined by its likelihood and the associated consequences.”

Determine Equipment and Resource Needs

During the preliminary needs assessment, rural communities can identify resource needs for community response. Potential resource needs include:

  • Workforce, including staff and volunteers, to support response
  • Communication tools and infrastructure
  • Emergency food and water
  • Health and medical services and supplies, including personal protective equipment (PPE)
  • Housing assistance and shelter
  • Mental health and counseling services and support
  • Transportation

Equipment and supplies are also important considerations. Stockpiles of supplies like PPE, first aid supplies, medications, and first responder equipment will help as supply chains are established during response. Rural communities should also consider which personal supplies may be needed for community members, such as blankets, clothes, batteries, fans, or heaters.

Technology equipment and requirements, like power and internet capabilities, are also important considerations in the response phase. Depending on the type of emergency, innovative and advanced technologies should be considered.

Case Study

Wayne Memorial Community Health Centers in Pennsylvania
In early 2020, when the COVID-19 pandemic response started to cause strain on healthcare systems across the United States, Wayne Memorial Community Health Centers created two separate systems for tracking patient calls and patient office visits regarding COVID-19. This enabled them to better tailor the information, resources, and services delivered to patients in the community.

Logistical planning is key to an effective response. For example, depending on the type of emergency, it may be necessary to establish emergency routes for evacuation and for bringing in resources for the response. Resource management may also involve identifying support and distribution systems. Distribution systems may also be needed for food, water, and shelter for community members affected by the disaster as well as first responders, staff, volunteers, and others involved in the response.

Another key resource for response is funding. See Module 6: Funding, Resources, and Support for Rural Emergency Preparedness and Response for additional information on the types of funding available to rural communities during a response and for guidelines on requesting assistance. It is important for communities to have an emergency reserve fund. This is cash that is reserved for use during emergencies. However, if local cash resources are insufficient, federal assistance can be requested through state partners.

Leverage Existing Infrastructure

Engaging the resources for a response involves extensive planning and coordination. Existing infrastructure can provide a strong foundation for effectively implementing emergency response activities and strategies. For example, vaccine delivery was an important strategy in the COVID-19 pandemic response. Operation Warp Speed Strategy for Distributing a COVID-19 Vaccine was a federal strategy for ensuring the equitable and rapid distribution of vaccines as they became available. This strategy relied on existing partnerships between the federal government and state, tribal, and local health department partners, with demonstrated success in distributing millions of doses of routine vaccines. For more information on immunization infrastructure, see The Role of Public Health and Health Systems, Facilities, and Providers in Emergency Preparedness and Response.

Utilize Evidence-Based Interventions and Stages

During a response, it is important to implement the activities and strategies that are proven to work. Applying the best available evidence in emergency preparedness and response is central to evidence-based practice. In 2020, the Health and Medicine Division (HMD), National Academies of Sciences, Engineering, and Medicine reviewed and evaluated the existing evidence on emergency preparedness and response practices in the report Evidence-Based Practice for Public Health Emergency Preparedness and Response. The report focuses on four preparedness areas: partner engagement and training, activation of emergency operations centers (EOCs), communication, and quarantine. Where there is limited evidence to support decision-making, rural communities can rely on effective, promising, or emerging approaches.

Deliver Open and Inclusive Communication

Clear and consistent communication is crucial during a response. Communication with partners during a response can occur through a variety of channels. There is moderate evidence to support use of electronic messaging systems, including email, fax, and text messaging, when communicating with technical partners. Communication strategies should ensure that every individual and organization involved in the response is receiving relevant and timely information. Using an organizational chart or matrix can help identify and ensure that all appropriate groups are receiving communication.

Rural communities can use warnings and emergency alerts to reach both technical audiences, such as response partners, and the general public. Wireless Emergency Alerts can be sent by local officials, the National Weather Service, or the President of the United States. The Emergency Alert System (EAS) is a national public warning system that allows local, state, and federal authorities to deliver information on incidents, such as weather emergencies, imminent threats, AMBER alerts, and other localized events. Locally, radio and television broadcasts can also be used to communicate with the public. For more information, see Public Safety and Crisis Communication in an Emergency or Disaster.

When communicating with the public, it is important to ensure equity and inclusion in your messaging. Using a Whole Community approach can help achieve equitable and inclusive communication. For more information on addressing the needs of populations and ensuring equity in emergency response, see Addressing Community Needs in Emergency Preparedness and Response.

Begin Actions to Enable Recovery

Even during a response, it is important to begin actions to enable recovery. Monitoring response progress as it occurs is crucial for the recovery phase. Rural communities should identify opportunities and strategies for information collection as the response is happening. Examples of data points and information collection that may help reinforce the planning process and improve recovery include:

  • Reach of the response
  • Populations affected by the disaster
  • Information dissemination, such as social media usage
  • Health outcomes
  • Resource usage
  • Funding needs
  • Workforce needs

For more information on data collection and evaluation, see Module 5: Post-Emergency Assessment and Sharing of Lessons Learned.

Resources to Learn More

FEMA National Response Framework, Fourth Edition
Outlines FEMA's National Response Framework and its guiding principles for responding to emergencies.
Organization(s): Federal Emergency Management Agency (FEMA)
Date: 10/2019

National Voluntary Organizations Active in Disaster
Offers a variety of resources, potential partners, and lessons learned for disaster response. A coalition of more than 70 national faith-based, community-based, and other nonprofit organizations; 56 state/territory groups, which represent local and regional organizations; and hundreds of other member organizations throughout the country that can help communities responding to disasters.

TRAIN Learning Network
Serves as a national learning network with online courses and resources related to emergency preparedness for agencies, organizations, and professionals working in healthcare, emergency preparedness and response, and public health. Requires a log-in but costs nothing to use.
Organization(s): Public Health Foundation