BACKGROUND The impending landfall of Hurricane Katrina on the Mississippi Gulf Coast resulted in large numbers of evacuees into the Jackson, Mississippi area. Many evacuees with chronic medical problems had been directed to the Mississippi Coliseum in the downtown area near the University of Mississippi Medical Center. As the storm passed through Jackson, serious damage occurred to the municipal infrastructure. In this article, we asked how that experience has affected health planning for the care of sheltered populations. METHODS We reviewed the information accumulated in the course of operating a large medical clinic for evacuees at the Mississippi Coliseum. We also contacted representatives of disaster planning agencies and of healthcare planning organizations to determine changes that have occurred in strategic plans subsequent to Katrina. RESULTS Using the resources of our academic health center, we were able to effectively deliver healthcare to sheltered evacuees. A model has been developed for future use from this experience. Much progress has been made toward preparation for care of the chronically-ill who may be displaced by future disasters. CONCLUSION Hospitals and clinics on major evacuation routes for natural disasters can expect the sudden necessity to provide care to evacuees. Unless plans to care for chronically-ill individuals are incorporated into hospital disaster plans, local healthcare facilities may be unprepared to provide care. Many evacuees will have limited resources to pay for services. Academic medical centers have unique resources and capabilities to lead in the care plans for these populations.