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During times of extreme storm events, access to rural areas involves bi-directional flow: (1) Evacuation of able-bodied individuals from affected areas and (2) Access to the affected areas by emergency and rescue personnel.
Why would Access be capitalized and why would you not put a comma after areas? Is there a particular rule?
Essentially there are two separate topics, so each is started with a capital letter. There is no need for a comma as the two topics are in this instance linked.
At the end of the day, capitalisation and comma are both a matter of individual preference. I don't think there can be an absolute rule.
Need assistance on correct punctuation 
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