PLANNING THAT SAVES LIVES

Originally published in Forbes.

The floodwaters came fast, but the failures in disaster planning had been building for years. The Texas floods that swept through Central Texas on July 4 claimed more than 130 lives and left over 160 people missing. Among them were young children, the elderly and those with medical or physical vulnerabilities — people least able to outrun rising waters or navigate chaos alone. The storm exposed not just physical fragility, but the cracks in our systems meant to protect those at greatest risk.

Search teams battled relentless rain as rivers swallowed neighborhoods, but for many, the greatest threat wasn’t the storm itself. It was the absence of a real plan when the systems meant to protect them collapsed. Here’s the kicker: 103 counties in Texas still don’t have FEMA-approved plans. But this kind of loss isn’t inevitable — there are concrete steps healthcare advisors, caregivers and families can take now to prevent it from happening again.

Disaster planning too often boils down to vague guidance: “Have a go-bag,” “Charge your phone,” “Check on your neighbors.” Well-meaning, yes. But a person with Parkinson’s who needs refrigerated medication or a ventilator-dependent patient in a flood-prone region needs their life-sustaining oxygen far more than a flashlight and granola bar. For them, generalized advice simply won’t cut it.

Experienced healthcare teams are uniquely positioned to close this readiness gap — by planning with precision, not platitudes. I’ve been directly involved in what real preparedness requires: I led emergency planning at Beth Israel Medical Center and trained at the Center for Domestic Preparedness, where the focus is on coordinated, hands-on response to large-scale public health threats. These experiences underscored a hard truth — preparedness must be personal, specific and proactive.

What the Texas Floods Exposed About Risk

Disaster preparedness begins with geography. A floodplain isn’t the same as a wildfire zone. Rural areas often lack emergency medical services; urban centers may be prone to power outages or overwhelmed shelters. Those of us who have worked in hospitals on emergency preparedness have done hazard vulnerability analysis for years. HVA is a systematic approach used to identify potential hazards, analyze their impact and prioritize planning and resource allocation. It’s a powerful tool that can be adapted for individuals and communities alike.

Helping patients assess their personal risk should be step one. The Federal Emergency Management Agency’s flood maps, Cal Fire’s fire hazard zones and NOAA’s climate data provide useful starting points. But providers must also ask: What disasters are most likely in this area? What infrastructure vulnerabilities exist? How resilient is this patient’s home setup?

The cost of ignoring these questions can be catastrophic. During Hurricane Harvey, 21% of hemodialysis clinics in Harris County, Texas, were flooded — the majority in FEMA-designated high-risk flood zones. For patients who rely on multiple treatments each week, this was more than a disruption — it was life-threatening. Overlaying patient addresses with hazard maps isn’t just a theoretical exercise. It’s a matter of triage.

Some clinics learned this lesson the hard way. Others got ahead of it. By identifying at-risk patients and relocating dialysis care before Harvey made landfall, several Houston providers were able to maintain access, minimize chaos and save lives.

Plan for Real-Life Needs, Not Hypotheticals

Effective emergency planning must be individualized. It means understanding the exact risks and needs of each patient and crafting a plan that considers both clinical and logistical realities.

For someone in a flood zone, the plan might include storing medication in waterproof containers, having laminated copies of health records, and identifying nearby shelters with appropriate medical support. It seems obvious, but seldom does this happen. Someone living in wildfire territory may need a high-efficiency mask for smoke protection, portable air filtration and cloud-based storage of medical records in case of evacuation.

In places vulnerable to extreme heat or cold, it’s about preparing for power failures: backup battery-powered oxygen machines, electrolyte supplies during heatwaves, thermal blankets and battery-powered heaters during cold snaps. Critically, it’s about timing. Advisors and providers should work with patients and pharmacies ahead of storm seasons to pre-authorize emergency refills and build medication stockpiles.

Keep Care Going — Even When Systems Shut Down

Continuity of care can be a matter of life or death. When clinics close, supply chains stall or the internet goes down, patients still need care. They still need medications. They still need access to clinicians and health information.

That’s why we all must think two steps ahead. Can a patient access telehealth in a blackout? Do they know which nearby health departments maintain vulnerable population registries? Have their caregivers been trained on emergency protocols? Are emergency contacts updated?

And it’s not just your patients who need a plan. It’s your parents, your spouse, your child with complex needs. Too often, families assume someone else has the plan — that the facility will handle it, that EMS will show up in time, that the oxygen tank will be delivered. But assumptions collapse under stress. If your mother is in an assisted living facility, do you know their exact emergency protocol? Will they evacuate her early? Do they have backup power, refrigeration for medications and trained staff who know her needs? Don’t rely on others to have all the answers. Ask now. Plan now.

Local partnerships are vital. Some communities, like Ventura County, California, have created registries to help emergency responders identify and assist high-risk individuals. Advisors should ensure their clients are registered and that emergency responders have relevant health information available in advance.

Community-based solutions also play a role. Empowering caregivers and even neighbors to step in with basic emergency training — how to assist someone on oxygen, what to do if insulin is spoiled — can create a failsafe system when the grid goes down.

Push for the Bigger Fix

While personalized planning is essential, it is not sufficient. Healthcare advisors, providers and policymakers must also push for systemic reform.

That means advocating for policy changes like designated “medical disaster zones” that fast-track federal aid to affected healthcare infrastructure. It means mandating emergency preparedness training for home health aides, especially in high-risk regions. It also means integrating health concerns into emergency drills and preparedness programs at the local level.

After California’s deadly Camp Fire in 2018, the state passed legislation requiring utility companies to fund backup power for medically vulnerable patients. This kind of legislation doesn’t happen on its own. It requires advisors, clinicians and advocates to speak up — and keep speaking up — until policy reflects the realities on the ground.

From Texas Floods to Future Threats: A Call for Resilient Healthcare

If you’re a healthcare advisor or provider, the next disaster is your signal. Assess patient risks now. Host a preparedness workshop. Coordinate with local agencies. Advocate for the policy fixes that will make the next crisis more survivable. And above all, get organized.

Preparedness is about more than surviving the storm. It’s about ensuring that patients retain dignity, access and agency when everything else is uncertain. And it starts with moving beyond one-size-fits-all advice.

The Texas floods were a warning — not just about climate risk, but about healthcare fragility in crisis. As extreme weather becomes more frequent and more severe, healthcare systems must evolve to meet the moment. That evolution starts with individual advisors but must scale to institutions, insurers and policymakers. Because the worst disaster isn’t the one that hits hardest. It’s the one we failed to plan for.

At Wellworth, we help families and family offices navigate these very issues — choosing the right coverage, finding top-tier care, and anticipating how changes in policy, demographics, and technology will shape tomorrow’s decisions.