Preparing for the Unexpected: The Role of Navigators in Continuity of Coverage and Care in Natural Disasters
January 7, 2025 | By Anita “Ani” Fête Crews
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In our recent blog on the responsibilities of Navigators year-round, we discussed how Navigators not only support enrollment in health insurance but also take steps to address health-related social needs such as food, housing, and benefits, working toward the goals of Healthy People 2030.
The community support Navigators provide is especially crucial in the wake of natural disasters like hurricanes, wildfires, droughts, and floods. As these weather-related emergencies become more frequent and severe, families face increasing instability from loss of housing, income, and employment.
Navigators play a vital role in disaster preparedness and response, ensuring access to coverage and health resources and connecting affected communities with disaster relief.
Natural Disasters Impact Health Coverage and Access to Care
Extreme weather and natural disasters negatively impact physical and mental health, as illustrated in the Fifth National Climate Assessment. At these vulnerable moments when people most need medical care, they may have a harder time accessing these services due to displacement from their homes or disruptions in the health care delivery system.
Looking through the lens of health care expenditures, we can see more specifically how disasters affect health care coverage and access:
- A 2017 report by Milliman examined health care claims following large hurricanes over the last decade. In the short term, researchers observed decreased claims, delayed payments, and more emergency department visits, while long-term effects included loss of coverage, poorer health outcomes, and sustained damage to hospitals and other health care facilities.
- A recent study published in Environmental Research: Health, which examined 4.7 million children with commercial insurance, found that extreme heat events led to more emergency department visits.
- A study published this year in Nature demonstrated increased emergency department visits and mortality among Medicare beneficiaries following exposure to natural disasters.
Navigators Contribute to Disaster Recovery through Enrollments
Navigators can step in to ease some of the health care challenges resulting from natural disasters, starting with outreach to those affected.
In the aftermath of a natural disaster, people may have a renewed interest in enrolling in health insurance. According to a 2023 study, people recovering from a series of hurricanes and floods in Louisiana were more inclined to seek health coverage.
Impacted individuals also may be eligible for a Special Enrollment Period (SEP). Find specific guidance at HealthCare.gov, which defines “unexpected situations” that trigger SEP eligibility.
How Navigators Can Prepare for Extreme Weather Emergencies
To effectively respond to natural disasters and other emergencies that disrupt health coverage and access to care, Navigators can take the following steps:
1. Learn the risks for your community
- Utilize tools like FEMA’s National Risk Index, which helps assess the risks specific to your county and the associated impacts.
- Understand the different vulnerabilities of the populations you serve, such as living alone, having pre-existing medical conditions (e.g., asthma, mobility limitations, or diabetes), and using a medical device requiring electricity.
- Define roles and responsibilities for Navigators in the event of a disaster, such as coordinating with local agencies, providing immediate support to affected communities, and ensuring continuity of health insurance coverage.
- Find emergency plan templates from Ready.gov and the CDC.
- Use the Climate Resilience for Frontline Clinics Toolkit, developed by the Harvard T.H. Chan School of Public Health and Americares, for immediate and long-term planning.
- Prepare backup communication channels if phone and internet services go down and key personnel are unreachable. Learn more about communication plans at Ready.gov.
3. Ensure data and consumer information are secure and accessible
- Create backup systems for consumer information. Ready.gov has a toolkit to create an IT-specific disaster recovery plan for businesses and organizations.
- Protect against data loss and create plans for protecting personally identifiable information.
4. Partner with local agencies and disaster response teams
- Build relationships ahead of time and collaborate with local FEMA agencies to ensure you know where to seek assistance or direct clients in an emergency.
- Connect with local health care providers and facilities, community health workers, local public health infrastructure, and county emergency response offices. Subscribe to their newsletters and follow them on social media to stay up to date.
5. Provide immediate and long-term support for affected communities
- Follow up with individuals in your network to confirm continuity of coverage. This ongoing communication is vital in ensuring that people are aware of the resources specific to coverage and care, as well as broader disaster recovery resources such as housing and financial assistance available in your community.
- Be flexible in revising previously developed outreach strategies and plans.
6. Create and distribute educational materials
- Remind consumers how to prepare when extreme weather is coming, such as ensuring sufficient medication and medical supplies (e.g., oxygen) to get them through the disaster and immediate aftermath, adding their member ID cards to their safe storage of important papers and documents, and making a plan for safe storage of medications that require refrigeration.
- Develop disaster-specific resources on using health insurance and accessing health care during disasters. This proactive step ensures that Navigators are prepared to assist in any situation. Ready.gov has a wealth of resources for individuals available in several languages.
7. Train Navigators in disaster-specific scenarios
- Provide scenario training for Marketplace and Medicaid/CHIP coverage emergency enrollments.
- Ensure navigators receive regular training on cultural competency. The federal Administration for Strategic Preparedness & Response has a helpful fact sheet on building cultural and linguistic competency in disaster preparedness and response.
8. Plan for ongoing communication post-disaster
- Build a follow-up plan to check in with your client population.
- Continue to share resources and information. Natural disasters and other emergencies can impact health coverage and access to care for a significant amount of time following the immediate event.
Go Further: Community Leadership and Building Resilience for the Future
Organizations of all types can prepare for the increasing frequency and intensity of natural disasters by adopting long-term policies and practices that build resilience. Programs like Climate Rx help health care providers and professionals educate patients and clients on their health, advocate for sustainable health care and coverage policies, and build individual and community resilience. Consider joining a Community Emergency Response Team (CERT) volunteer team or designating a staff member to be trained in essential disaster response assistance.
By preparing for the unexpected, Navigators can be well-positioned to support communities and ensure that clients and the broader community continue to receive the care and assistance they need even in times of crisis.
Transform Health is a nationally certified women and minority led health care consulting firm. Reach out to us today if you would like to work together. Contact Heather Bates, COO, and VP of Stakeholder Engagement at heather@transformhc.com. We would love to hear from you!