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Advisory Council July 2020 Meeting Presentation: At-Risk Individuals Program and COVID-19

Monday, July 20, 2020

Printer Friendly Version in PDF Format (8 PDF pages)


At-Risk Individuals Program and COVID-19

Cheryl A. Levine, PhD
Senior Advisor, At-Risk Individuals Program Director
Assistant Secretary for Preparedness and Response (ASPR)
US Department of Health and Human Services (HHS)

Background on ASPR

Public Health Emergency screen shot.

ASPR Mission

Save Lives and Protect Americans from 21st Century Health Security Threats

ASPR/At-Risk Individuals (ARI) Program

  • COVID-19 Response -- HHS/FEMA Community Mitigation Workgroup
  • Team includes 2 ASPR/ARI personnel and multiple COVID-19 Rotations

HHS Requirements for At-Risk Individuals

  • The Public Health Service Act ( forms the foundation of HHS’ legal authority for responding to public health emergencies as amended by the 2019 Pandemic And All-Hazards Preparedness and Advancing Innovation Act (PAHPAIA) (
  • Pandemic and All-Hazards Preparedness and Advancing Innovation Act (2019) updated language under the Public Health Service Act (PHSA)
    • Section 2802 requires taking into account the public health and medical needs of at-risk individuals. It defines at-risk individuals as children, pregnant women, older adults, individuals with disabilities, and others who may have access or functional needs in the event of a public health emergency as determined by the Secretary of Health and Human Services.

Access and Functional Needs (AFN) Population

  • Children
  • People Who Live in Institutional Settings
  • Older Adults
  • Pregnant Women
  • People with Disabilities
  • People with Chronic Conditions
  • People with Pharmacological Dependency
  • People with Limited Access to Transportation
  • Limited English Proficiency/Non-English Speakers
  • People with social and economic limitations
  • Individuals Experiencing Homelessness

At-Risk Individuals, Behavioral Health & Community Resilience (ABC) Library -- Older Adults

  • HHS/ASPR Access and Functional Needs Web-Based Training
    • Defines the concept of “access and functional needs” (or AFN) of at-risk individuals including older adults, people with disabilities, people with chronic health conditions, etc.
    • Approach for addressing a common AFN irrespective of specific diagnoses, status, or labels
    • Tools for addressing AFN during disaster preparedness, response, and recovery activities
  • Working with Older Adults and People with Disabilities: Tips for Treatment and Discharge Planning
    • Considerations for public health planners and emergency responders when older adults require temporary placement in a healthcare facility during a public health emergency
    • Steps to take to ensure discharge planning is person-centered and places these individuals in the least restrictive environment that meets their needs

Capacity-Building Toolkit

  • Version 2.0 published June 17th, 2020
  • National Association of County and City Health Officials (NACCHO)
  • Association of State and Territorial Health Officials (ASTHO)

Purpose of the Capacity-Building Toolkit

  • Ensure equal access to our nation’s emergency preparedness, response and recovery resources
    • Provide information and resources for the Aging and Disability Networks to become more engaged in emergency planning (CBO Readiness)
    • Advance whole community planning and supporting consumers (Consumer Planning)
    • Develop partnerships with emergency management and public health officials (Partnership)

Emergency Planning for Organizations

  • Identify hazards
    • Conduct risk assessments
  • Create an Emergency Operations Plan
  • Understand the Incident Command System (ICS)
  • Understanding the Emergency Support Functions (ESF)
  • Participate in trainings and exercises
  • Engage in consumer advocacy
    • Participation in exercises
    • Inclusion in emergency plans
Figure 1: The Phases of Emergency Management
  • Preparedness: Preparing to handle and emergency
  • Response: Responding to an emergency
  • Recovery: Recovering from an emergency
  • Mitigation: Minimizing the effects of an emergency

COVID-19 ARI Activities to Date

  • Foster relationships with new and existing stakeholders
  • Collaborate with partners to create and promote resources and guidance
  • Support expanding and maintaining of nutritional resources
  • Develop journey maps and other resources for providers serving AFN population

Sustaining Nutritional Needs for At-Risk Individuals

  • Guidance for federal agencies and state, local and territorial governments to sustain and expand home delivered meals and other nutrition programs through:
    • Identifying need
    • Building capabilities
    • Engaging networks
    • Creating solutions
  • Provides information on leading practices and existing programs that provide nutrition services for at-risk individuals
  • Includes overview of government programs that address nutritional needs

ARI Program: Recent and Forthcoming Products

COVID-19: Novel Coronavirus Disease

Information about ASPR’s efforts to protect the nation from this novel disease are available online at

Public Health Emergency COVID-19 Home Page screen shot.