The Rhode Island Special Needs Emergency Registry--An Opportunity for Expanding the Healthcare Provider's Role in Health Equity.

These insightful words provided by TFAH reflect Rhode Island’s aspiration to achieve health equity, but require expansion to address health security. All citizens should have the opportunity to be healthy by accessing services regardless of who they are, where they live, and whether or not an emergency is happening. The American Medical Association’s Declaration of Professional Responsibility references that the healthcare community, as a whole, takes ownership for safeguarding the health of patients who are under medical care to earn society’s trust in the healing profession.2 Thus, do providers inherently challenge themselves to consider what they can do for patients to also prevent health disparities from occurring during and after a disaster? Rhode Islanders who report having a disability or diabetes are more likely to be prepared (25.1% and 26.2%, respectively) than those without a disability or diabetes (18.3% and 19.2%, respectively).3 The Federal Emergency Management Agency (FEMA) and Ad Council report 81% of Americans are not very prepared for an emergency,4 increasing the likelihood for relying upon outside assistance. Being prepared should include having an emergency plan and an emergency threeday supply of water, food, and medications. Higher personal and community preparedness can minimize reliance upon first responders for the first three days after an emergency. The Rhode Island Special Needs Emergency Registry (RISNER) was established in 2007 by the Rhode Island Department of Health (RIDOH) and the Rhode Island Emergency Management Agency. RISNER strives to identify individuals with disabilities, chronic conditions, or other special healthcare needs. Residents who use life support systems, have mobility or assistive devices, utilize a service animal, or require assistance due to cognitive/developmental needs are the primary focus. Residents of assisted living/ nursing facilities are not eligible for enrollment since those facilities have trained medical staff and are already prioritized by first responders (e.g., police, fire, and emergency medical services). Outreach has predominantly focused on community-based organizations, first responders, and individuals. The information within RISNER is kept strictly confidential at the state/municipal level. Data are only shared with first responders to assist in responding to 911 calls and with local/state emergency management staff to protect individuals’ safety and well-being during emergencies. While enrollment in RISNER does not guarantee assistance, the system allows first responders to effectively plan for, prepare for, and respond to community needs. This article briefly describes the demographics of enrollees and recommends ways RISNER can be utilized as a tool for healthcare providers seeking to protect and prepare their patient population.