In July 1994, tropical storm Alberto brought heavy rains to parts of Alabama, Florida, and Georgia. In South Georgia, rivers rose 44 feet above flood stage, muddy water covered 10,000 square miles, and 31 lives were lost. In implementing the Health and Medical Services portion of the FEMA Federal Response Plan, the Public Health Service learned lessons from this experience that can be applied to planning for other natural disasters. Continuous reassessment to assure the best utilization of resources in rapidly changing conditions, cross-training in the content of emergency plans at all levels, and on-going face-to-face liaison among response managers will improve response efforts. Populations with special medical needs must become part of any response design. The effects that any response activity may have on the community as a whole should be carefully considered before action is taken.