Overview

Disasters – large scale events that have an extreme impact on life and property – disproportionately affect people with disabilities. They are more likely to have difficulty evacuating without assistance, are more likely to be segregated in shelters, and have more difficulty recovering in the disaster’s aftermath. Individuals with disabilities who are independent in their day-to-day lives may lose access to their caregivers (e.g., paid staff, family members or friends), transportation, accessible living or working environments and assistive technologies.

People with disabilities are significantly less prepared than the general population, and are more likely to be severely impacted by the disaster. Assistive technology (AT) is critical to the independence and well-being of people with disabilities; in an emergency or disaster, access to AT may mean survival and/or the difference in recovery from the event. Thus, involvement of AT Act Programs in emergency management efforts is a natural fit.

Getting Started

One of the first steps to engaging in statewide emergency management (EM) efforts is to become familiar with the structures and terminology used in these efforts on the national, regional, and local levels. For example, the term “access and functional needs” is the current terminology used by emergency managers to refer to people with disabilities (although this term also includes older adults and people with permanent or temporary medical conditions as well as individuals who do not speak English).

Four Phases of Emergency Preparedness

Emergency preparedness is typically conceptualized as having four phases: Preparedness, Response, Recovery, and Mitigation.

Personal Preparedness

Emergency preparedness is based on the notion that there are certain predictable factors that will occur in an emergency or disaster, and the effects of these factors can be reduced or eliminated by taking steps in advance of the occurrence. The Federal Emergency Management Agency (FEMA) and the respective state emergency management agency, the Centers for Disease Control (CDC) as well as state public health agencies have online resources to promote personal preparedness for people with disabilities. Another resource is the AT3 Center blog article Assistive Technology Tips for Emergency Prep.

Emergency Response

First responders include personnel such as police, fire, and other emergency workers who may be involved in assisting people with disabilities in safely evacuating their premises (whether at work or home) and in some cases transporting them to emergency shelters. It is helpful for first responders to understand the nature of various disabilities (including issues related to communication) and the importance of AT, and to have training on these topics. Agencies responsible for operating shelters may need assistance in developing, acquiring and deploying assistive technology resources that will enable people with disabilities to be safely housed in an accessible “general population” shelter when appropriate, rather than segregated in a restrictive medical needs shelter. AT Act Programs have developed resources to help train first responders as well as shelter personnel; suggested lists of AT for shelters (including not limited to AT for mobility and communication); and strategies to identify AT needs of survivors in the shelter.

Recovery

Recovery from emergencies and disasters may take a long time, depending on the extent of the damage. For example, restoring damaged infrastructure and reliable power and phone services may take months or longer. Many individuals with disabilities may lose their AT; others may have new and unmet needs for AT devices and services because of injuries sustained during the event. While federally declared disasters may be eligible for financial assistance to replace damaged AT, available funds may only cover part of the loss, or it may take a long time to receive help. Equipment that is older but still in good working condition (Reused AT) can be a valuable resource to provide individuals with needed AT while waiting for a replacement.

Another way that some AT Act Programs work within their states and territories is to develop resources for shelters or individuals before or after a disaster.  For example, some AT Act Programs developed emergency kits that can be dispatched as a unit or as singular items to shelters and/or to individuals following a disaster.

Mitigation

The mitigation phase of emergency management refers to efforts related to reduce the (future) impact of emergencies. This may include additional steps in planning, training, and community preparation. For example, AT Act Programs may develop Memoranda of Understanding with community partners and EM officials that outline the ways in which the AT Act Program may be called upon in the event of a disaster declaration.

Health and Post-Pandemic Guidelines and Resources

The COVID -19 pandemic taught many lessons about health emergencies.  While the COVID public healthcare emergency expired in May 2023, there are many resources from federal agencies and other entities that are still relevant for individuals with disabilities. The resources have been updated by the agencies to provide the most current information.   The Centers for Disease Control and Prevention has shifted from an emergency response to incorporating COVID-19 activities into sustainable public health practice.

Everyone should practice regular preventive care. The CDC’s website has many resources including guidance regarding symptoms, and what to do if you feel sick: CDC Covid-19 Information and How do I get a COVID-19 Vaccine?

Among the many resources on the CDC website is guidance designed to assist citizens in cleaning and disinfecting public spaces including your workplace, school, home, and business. Explore the CDC Guidance on Cleaning and Disinfecting.

The Administration on Community Living (ACL) has a website with information about the end of Medicaid continuous coverage and other changes connected to the end of the public health emergency and the major disaster declaration, vaccinations, and testing.  It also includes resources including the Disability Information and Access Line (DIAL) and ACL’s Eldercare Locator.

During spring and summer 2020, AT3/ATAP engaged  AT Act Programs about their response to the COVID-19 pandemic. This report, AT Act Programs COVID-19 Response Summer 2020 provided insights into how the AT Act Programs adapted to meet the demands of the COVID environment and safely provide services to individuals with disabilities of all ages including older adults.

Health Insurance Coverage

Because of the impact of this emergency on health insurance, it is important to review materials that relate to coverage for assistive technology devices and services.

In addition to information coming from international sources such as the World Health Organization (WHO), the federal government, including the Centers for Disease Control (CDC), you should check with your state regarding issues like authorization for, delivery of, and funding for tele-rehabilitation services.

The Centers for Medicare & Medicaid Services (CMS) website has helpful information for AT programs to understand the waivers and flexibilities available to public programs for the COVID-19 emergency.

Department of Education

The U.S. Department of Education’s Covid-19 Resources page includes guidance and policies related to elementary and secondary educationspecial education, postsecondary education, and other aspects of lifelong learning. The Centers for Disease Control and Prevention (CDC) also continues to provide updated guidance for school settings.

Department of Health and Human Services (HHS)

Office of Civil Rights (OCR)

OCR has issued guidance reviewing legal standards and best practices for improving access to COVID-19 vaccination programs and ensuring nondiscrimination on the basis of race, color, and national origin. Whether information is distributed via flyers, online information portals, or in person at vaccine distribution sites, there is a legal obligation that COVID-19 vaccination programs be accessible and free of discriminatory barriers that limit a communities’ ability to receive vaccinations and boosters. The new guidance ensures that entities covered by civil rights laws understand their obligations under Title VI of the Civil Rights Act of 1964 and Section 1557 of the Affordable Care Act, laws requiring that federally assisted health care providers and systems ensure fair, equitable access to vaccines. Recipients of Federal financial assistance includes state and local agencies, hospitals, and health care providers administering vaccines and boosters.

Telehealth Services

The U.S. Department of Health and Human Services took a range of administrative steps to expedite the adoption and awareness of telehealth during the COVID-19 public health emergency. Some of these telehealth flexibilities have been made permanent while others are temporary.  The Department has created a hub of current telehealth information for consumers, providers and others.

Administration for Community Living (ACL)

The Administration for Community Living (ACL) has a resource page that covers the unwinding of policy changes due to the COVID-19 pandemic.  This includes information on Medicaid continuous eligibility, changes for state units on aging, civil rights protections and other important information.

Another resource is the National Rehabilitation Information Center (NARIC), which is funded through ACL.  NARIC collects publications of grantee community publications of the National Institute of Disability, Independent Living and Rehabilitation Research (NIDILRR) on their COVID-19 Special Collections web page.

Sanitization/Cleaning of Phones and Electronics

While the CDC recommends you wash your hands frequently and avoid touching your face, it is harder to clean the other things that touch your face – especially your phone. When reviewing advice and products, note whether there is a claim to kill bacteria or viruses. Even if it is “only” going to take care of bacteria, it doesn’t hurt to clean your electronics!

Apple advice on how to clean your apple products.

PC magazine addresses “spring cleaning” for a variety of electronics, including headphones, phones, and tablets and laptops.
How to Disinfect Your Phone and Electronics From Viruses and Germs

Ultraviolet Radiation (UV)

The application of UV radiation in the health-care environment (i.e., operating rooms, isolation rooms, and biologic safety cabinets) is limited to destruction of airborne organisms or inactivation of microorganisms on surfaces. The effect of UV radiation on postoperative wound infections was investigated in a double-blind, randomized study in five university medical centers and the investigators reported the overall wound infection rate was unaffected by UV radiation, although postoperative infection in the “refined clean” surgical procedures decreased significantly (3.8%–2.9%). No data support the use of UV lamps in isolation rooms.

New CDC Study Confirms Effectiveness of UV-C Disinfection to Combat Harmful Pathogens

What are ultraviolet (UV) light sanitizers?

UV light is nature’s disinfectant, but can it kill coronavirus?

Managing Anxiety

The challenges associated with the pandemic were stressful, overwhelming, and caused strong emotions in adults and children. Public health actions, such as social distancing, were necessary to reduce the spread of COVID-19, but they also could make us feel isolated and lonely and sometimes increased stress and anxiety. With the end of the national emergency, dealing with these challenges are no less important.

The CDC offers healthy ways to cope with stress.  Learning to cope with stress in a healthy way will make you, the people you care about, and those around you become more resilient.

The AT3 Center offers helpful information in the “AT News and Tips” blog, AT for Managing Anxiety.  Follow and explore the AT3 Blog for a wide variety of interesting AT information.

Advocacy

National Disability Rights Network (NDRN) has a variety of resources related to key areas of concern for people with disabilities in this national crisis. The NDRN website has links to topical briefs including issues related to transportation, housing, rationing of health care, incarceration, and special education. There’s also an accessible video guide (with captions available in English, Spanish, and simplified Chinese) targeted at people in group homes, nursing homes, and other residential facilities.

Material for Families

AT Act programs may be the only entity available to assist consumers with information particular to assistive technology devices and services. This may especially be true for families who rely on the schools for AT services for their children. PrAACtical AAC has a comprehensive compilation of materials to explain the virus (e.g., social stories); visual supports for handwashing; visual schedules (especially good to have if parents are suddenly home schooling!) and communication (sample boards; symbols; vocabulary).
PrAACtical Resources: Dealing with the Covid-19 Pandemic

Relevant AT3 Center Blog Posts

The AT3 Center’s blog, “AT News and Tips”, has topics of interest and relevance for emergency management and resources. Subscribe to our AT News and Tips blog for emergency management resources and more in-depth information about assistive technology devices, services, and innovations from the AT Act programs. Follow and Explore the AT3 Blog for interesting AT information.

AT3 COVID-19 Webinars

You can find COVID-19 related webinars on our Webinars page.

Resources

AT Act Programs in the time of Corona Virus (COVID-19) Webinar Recording
Recommendations for Emergency Managers For Improving the Delivery of Disaster Assistance to Disaster Survivors with Disabilities (pdf) (March 2019).

This document, produced by US Department of Homeland Security (DHS) Office for Civil Rights and Civil Liberties, is a synthesis of information gleaned from listening sessions held in communities affected by the 2017 and 2018 natural disasters. Recommendations support the engagement of AT Act Programs in all phases of emergency and the promotion of personal preparedness of people with disabilities, especially those who use power-dependent assistive technology and durable medical equipment.

Preserving Our Freedom: Ending Institutionalization of People with Disabilities During and After Disasters (pdf). Specific recommendations that involve assistive technology are included.

The National Council on Disability (NCD) recommends the Federal Communications Commission (FCC) reestablish their Emergency Access Advisory Committee to establish effective communication access requirements for alerts, warnings and notification, including provision of American Sign Language and other existing and new assistive technology. These guidelines should be developed in consultation and collaboration with the U.S. Department of Justice (DOJ), applying the requirements for equal effective communication access. Implementation should include monitoring and enforcement by the FCC and the Department of Justice.

NCD recommends that the U.S. Department of Health and Human Services (HHS) establish a process for states and territories for loaning and replacing durable medical equipment, consumable medical supplies, assistive technology, disability services and supports, as well as disaster case management to disaster survivors with disabilities in order to provide equal access and non-discrimination throughout emergency response to meet immediate health, safety, and independence needs.