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The Cayman Islands has established a shelter in every district to house and feed people before, during, and after a crisis. This function of the HMCI is controlled by the Essential Relief Services subcommittee, headed by the Department of Children and Family Services Director Deanna Look Loy.

As Hurricane Ivan began its approach, the shelters were prepared for use and opened on Friday, 9 September, at 1PM.

Medical relief personnel worked closely with the subcommittee to transfer elderly, infirm, and disabled citizens from their residences to the shelters designated as emergency medical centres (EMCs).

As the storm changed course and it became obvious that Grand Cayman would bear the brunt of the storm, more and more persons sought the safety of the shelters. At final count, there were over 3,000 persons in the official government shelters but as conditions continued to worsen, people sought shelter in other locations. Some of these 'unofficial' shelters were the Agape Family Church and the Church of God Family Life Centre, and many employees rode out the storm in their office complexes.

Some of the shelters remained open to accommodate persons who were homeless after the storm. Many of the sheltered were able to find accommodation with friends or family within the community which eased the transition of shelters returning to their normal function. The last shelter was closed in December 2004.

As a result of Ivan, works have been done to replace and reinforce roofs and upgrade generator capacity.