O3001: Home Assessments for Patients and Families with Special Health Care Needs: developing Tools, Communication Strategies, and Standards

Background: Children and youth with special health care needs (CYSHCN) account for 19% of all children. Their technology, chronic illness, and mobility challenges place them at significant risk during emergencies/disasters that disrupt utilities/require evacuation. Thus, they require
targeted education and preparation before disasters to minimize harm and ensure their safety.
As such, our team conducted home assessments to better understand the emergency preparedness needs in homes of CYSHCN, including those living in poverty, with limited English proficiency, and in both urban and rural areas in PA. In addition, we sought to examine the effectiveness of a standardized home assessment for CYSHCN partnering with social workers, medical equipment providers, community health workers, parent advisors, and local/state agencies to prepare families for emergencies and disasters.

Methods: An interdisciplinary home assessment team (social worker, medical equipment provider, bilingual community health worker, research assistants, medical legal partnership) conducted home assessments (virtually-Zoom in the pandemic) for 149 families w/CYSHCN across PA.
Each family and CYSHCN participated in an initial assessment with the interdisciplinary home assessment team and follow up assessment with the team in 3-6 months utilizing our home assessment tool.
Our home assessment tool consisted of five primary domains:
1.) Diagnostic Demographics
2.) Equipment/Assistive Technology Requirements
3.) Household Environment
4.) Emergency Planning
• Fire Safety
• Two scenarios:
• Home Evacuation
• Shelter-in-Place
5.) Social Determinants of Health

Following the initial home assessment, the team creates/distributes a resource package for families, including: a standard packet of disaster and emergency preparedness resources, shelter in place plans, and additional resources and community supports based on identified need. All participants receive gift cards for participating in both the initial and follow up assessments.

All families participated in a brief qualitative semi-structured interviews at the conclusion of their follow up visit assessing their experience, feedback and areas for opportunity with this home assessment intervention.
All data is recorded and stored in password protected computers in a red cap database. This project was approved by Drexel University IRB.

Results: A total of 149 subjects have been enrolled and completed initial and follow up visits in this study.

Subjects-CYSHCN had at least 1 diagnosis categorized as:
- Medical Equipment/Utility Dependence
- Physical/Mobility Impairment
- Communication Challenge (i.e., ASD, LD, IDD)
- Vision/Hearing Loss
Approximately, 24% of subjects enrolled met criteria for rural locations according to the Census Bureau and RUCA classification.
Approximately 27% of interviews were conducted in a language other than English with a certified interpreter.

Conclusion: Home assessments are a feasible intervention to support CYSHCN and their families yielding favorable associations in getting families needed resources and supports during an emergency. Future and further investigation of family experience with this intervention will prove to be valuable and contribution to generalizability and sustainability.