In the past decades, the United States has experienced a growing number of serious weather-related events like hurricanes, tornadoes, and flooding. Additionally, the COVID-19 pandemic has demonstrated both the strengths and weaknesses of the healthcare system in responding to emergencies. As the country seeks to mitigate harm in response to disasters, it is critical to recognize the potential of home healthcare workers and agencies.

In response to the 9/11 terrorist attacks, President George W. Bush signed into law the “Homeland Security Act of 2002” (Public Law 107-296). This act established the Department of Homeland Security with its mission of helping prevent, protect against, and respond to acts of terrorism.

The Emergency Preparedness and Response portion of the law directs the Secretary of Homeland Security to develop, fund, and carry out public health-related activities to help communities to prepare and respond to disasters. In this effort, the Secretary assists state and local government personnel, agencies, or authorities, non-federal public and private healthcare facilities and providers, and public and non-profit health and educational facilities, to prepare for, identify, prevent, and respond to public health emergencies of any kind.

In the fulfillment of this mission, billions of dollars have funded projects for first responders like law enforcement officers and firefighters. Money has also gone to upgrading security efforts in seaports and airports. In the public health arena, the department has supported hospital clinics and other traditional healthcare institutions. Unfortunately, home care and hospice providers are just beginning to be recognized as part of the emergency response network. Even when they are included, plans for home care providers in emergencies often reflect misconceptions about their abilities.

A bias toward traditional healthcare institutions has led to a poor understanding of home healthcare in both emergencies and nonemergencies. Typically, these highly skilled professionals are seen as a fill-in resource to augment hospital staff or provide transportation to local shelters. This attitude misses an opportunity to take advantage of the strengths, community relationships, and structure inherent to home healthcare and hospice programs.

In times of emergency, home healthcare agencies are already on the front lines of public health efforts in the community. Visiting aides, nurses, and therapists can help with community-wide programs such as vaccinations, sharing public health information, educating patients and families on disease prevention and management, as well as being a remote staff providing healthcare when hospitals are overcrowded. An important strength of such agencies is their ability to provide care in non-traditional settings, making them well-suited for working with patients in shelters and other temporary gathering spaces.

Programs geared toward responding to public health disasters should look to strengthen the community-centered infrastructure of the home health sector, recognizing and utilizing its unique abilities. The connections and services these agencies bring to homes in local communities will be essential to disaster preparedness and response efforts.

As home health solutions grow in popularity and practice, they can serve as connective tissue for bringing care to broad communities. Home healthcare programs provide services in rural and underserved areas. In some counties, public home care agencies are the primary providers of health services. With such familiarity with their communities, home healthcare agencies can efficiently deploy health resources in an emergency.

The community-based model used by home care clinicians requires a comprehensive approach. They have been trained to be aware of the patient’s living environment as well as their symptoms. Because they have regular contact with their patients, they can often recommend preventative steps to improve their health and safety. These healthcare workers often work cooperatively with family members, educating them on sanitation and infection prevention procedures. These one-on-one skills are essential in improving the overall health of communities.

To acknowledge the importance of home healthcare systems, home providers must be classified as essential health workers, receiving official credentials, access to emergency communication systems, and other considerations. They should also be included in community disaster response programs and given a greater voice that recognizes their unique contributions. Regarding home healthcare clinicians as a secondary resource during emergencies overlooks the powerful connections and support they are already providing in their communities.