By Dina Klimkina, program manager, The Council of State
Governments Center of Innovation
Twenty six percent of adults in the U.S. have some type of
disability. These disabilities may impact mobility, cognition, the ability to
live independently, hearing, vision or the ability to care for one’s self. Nearly one in four women have a disability,
and half of all individuals with a disability are over the age of 65.
Disability
is a natural part of the human experience that in no way diminishes one’s right
to fully participate in all aspects of community life. While many states have
worked to improve the lives of individuals with disabilities through
initiatives focused employment, education, transportation and other needs, now
more than ever it is important that states address the rights and needs of
individuals with disabilities in the wake of the COVID-19 planning and
response.
States have taken critical steps to ensure
safety, including school closures, crowd limits, state curfews and restaurant
and bar closures, among other measures. However, it important that states consider the potential
effects on their more vulnerable citizens.
While individuals with disabilities are not inherently at
a greater risk for contracting COVID-19, individuals with disabilities may be
more affected by disruption of services, including:
- Home and community supports and service
provision;
- Access to education;
- Access to information;
- Access to steady employment;
- Access to healthcare; and other critical needs.
Service Provision
Individuals with disabilities may have a challenge with
social distancing as some rely heavily on community-based and in-home service
provision. Service provision ranges across many categories, including anything
from therapy to delivery of goods, meals and medications. States leaders should
think strategically about how to ensure services continue to the most
vulnerable populations, including the development of plans for food
distribution, care for those in quarantine or prescription delivery. Continuity
of operations for services and supplies that assist people with disabilities
and older adults is critical for ensuring individuals maintain their health,
safety, dignity and independence.
For example, California
Executive Order N-25-20 ensures that individuals with developmental
disabilities continue to receive the services and supports mandated in their
individual programs and plans that are threatened by disruptions caused by
COVID-19.
Kentucky Gov. Andy Beshear issued Executive
Order 2020-257 regarding the state of emergency in Kentucky. The order
mandates that only life sustaining businesses may remain open, with the
exception of organizations that provide charitable and social services. These
organizations include “food banks, when providing food, shelter, and social
services, and other necessities of life for economically disadvantaged or
special populations, individuals who need assistance as a result of the
emergency, and people with disabilities.”
Access to Education
Over
45 states have, to some extent, closed all public elementary, secondary and
post-secondary schools. Lack of access to regular school days can be
particularly challenging for the 6.7 million public
school students with disabilities. School days can provide valuable
structure, development, training and sense of community.
Under Title II and Section 504 of federal statute, school
officials have an obligation to avoid discrimination of students on the basis
of disability and therefore must ensure provision of education services if the
student has an individualized education program (IEP) or is receiving services
under section 504. However, this applies only if the school is providing
instruction to other students. In other words, if a school is not educating
other students they are not mandated to provide education services to students
with disabilities.
E-learning technology can be used to provide students with
high-quality educational instruction during an extended school closure. However,
online instruction materials should be provided through adapted accessible
communication strategies.
In New York City, school officials have noted that they will soon
begin to contact parents to begin arrangements for their students’ individual
plans for remote learning. According to officials, teachers will conduct
individual education plan meetings by phone, and therapists will provide
teletherapy alongside schools’ remote instruction plans. The city has also
released resources on Diverse Learning at Home for
Special Populations, which
includes assistive technology support as well as specific occupational,
physical and speech therapy activities for students.
However, some areas are not engaging in online learning due
to lack of equity or access for all students. Kentucky’s largest school
district is specifically not moving to online learning due to concerns with
accessibility and internet access. However, the school district has provided
resources for non-mandatory
online learning. A Washington
State school district acquired 4,000
devices and additional internet access to low-income students but had to
revert the plan due to risk of violating access to equitable services. It is
critical that at home learning plans do not increase the gaps in education.
The U.S. Department of Education has issued a webinar
and fact
sheet for protecting students civil rights during COVID-19 response.
Access to Information
Individuals with disabilities must have access to credible
and timely information. Any changes to systems which provide services, affect
living or employment arrangements or can help individuals minimize their risk
of infection must be communicated to all members of the community.
It is critical that state agencies provide public
information in a way that is accessible for the most members of the community.
State leaders should consider using the
following tools to ensure accessibility of information:
- Public announcements should be live-captioned
and accompanied by qualified sign language interpreters. Numerous states are
ensuring that all citizens have access to the state’s COVID19 updates,
including citizens that are deaf or hard of hearing. For example, Rhode
Island , Kentucky,
Ohio
and Illinois
ensure there is an American Sign Language interpreter at each of the governors’
daily press briefings.
- Websites must be accessible for individuals with
a variety of disabilities, including individuals who use assistive technology.
Learn more on how to improve website accessibility here and use the
following tool to check your
current site.
- Communications should utilize plain and simple
language to maximize understanding.
- States can develop tools specifically made for
individuals with disabilities that help break down the risks of the virus, for
example the Coronavirus
Information and Guidance for People with Disabilities developed by the
office of Texas Gov. Gregg Abbott.
Access to Steady Employment
Individuals with disabilities are a critical part of the
state workforce. Yet, a significant percentage of people with disabilities have
difficulties finding, securing and retaining employment. In a time where many
individuals are facing possibility of unemployment, state governments must work
to ensure that individuals with disabilities are able to continue to work or
return to work following social distancing.
To facilitate continued employment, states may want to
consider promoting the use of teleworking policies. The Americans with
Disabilities Act (ADA) requires employers with 15 or more employees to provide
reasonable accommodation for qualified applicants and employees with
disabilities. The Equal Employment
Opportunity Commission (EEOC) guidance on COVID-19 notes that employees
with disabilities may request reasonable accommodations in response to the risk
of exposure to the coronavirus. Allowing individuals with disabilities to work
from home can be considered an accommodation. To learn more about reasonable
accommodation requests and COVID-19 please visit the Job
Accommodation Network.
The Stay-At-Work/
Return-to-Work Toolkit is a resource designed to help state officials
increase the employment retention and labor force participation of individuals
who acquire and/or are at risk of developing work disabilities, whether
on-the-job or off-the-job.
Policymakers can also continue to develop innovative
workforce policies and strategic workforce development plans, ensuring that
individuals with disabilities also have access to high quality meaningful
employment opportunities.
For example, during
the COVID 19 pandemic, Texas is still working to ensure people with
disabilities have access to employment services. The Texas Workforce Commission
released a statement
that emphasizes that the agency is working hard to continue to
provide of services to their customers. One example of overcoming the
current situation to ensure that services are still provided is that the
Workforce Commission has developed a procedure in which vocational
rehabilitation counselors can issue and approve service authorizations
electronically. This allows for the continuation of services remotely without
human contact.
To learn more about how states can improve their disability
employment policies read CSG’s Work
Matters: A Framework for States on Workforce Development for People with
Disabilities.
Access to Healthcare and Medication
All individuals with disabilities are not at higher health
risk for contracting COVID-19. However, many individuals with weakened
immune systems or those with disabilities that affect their respiratory
capacity may be at a higher risk of serious illness or death from a COVID-19
infection.
Currently, hospitals across the country are experiencing
shortages of life saving equipment, including ventilators, personal protective
equipment and other critical tools. There are concerns
that the lack of capacity within the U.S. healthcare system will result in “rationing
of life saving care for individuals with pre-existing illnesses and
disabilities.”Some
states have begun to explore rationing measures, while others have begun to
develop ethics committees and patient selection frameworks based on condition,
preexisting health problems and age.
Minnesota,
New Jersey, Oregon,
Texas
and Virginia,
have all released executive orders related to consolidating efforts, postponing
non-essential treatments and/or conserving resources within hospitals. To
conserve equipment and increase safety, the executive order from Oregon
prohibited all non-essential procedures and required that all clinics,
hospitals and outpatient procedures notify the state’s PPE coordinator off all
available equipment and surplus supplies. Similarly, New Jersey Executive
Order 109. ordered any business in New Jersey possessing PPE, ventilators,
respirators or anesthesia machines that are not required for the provision of
critical health care services, to be reported to the state. The order from
Virginia permitted the State Health Commissioner to authorize any general
hospital or nursing home to increase licensed bed capacity to respond to
increased demand for beds resulting from COVID-19.
To comply with federal law, state health departments
should follow the non-discrimination requirements of the Americans with Disabilities Act (ADA),
Section
504 of the Rehabilitation Act and Section
1557 of the Affordable Care Act in making treatment decisions.
Protecting Individuals in Facilities, Residential Care
and Chronic Disease Hospitals
Within medical institutions, best practices indicate that
administrators should follow strict hygiene and physical distancing policies,
as well as updated more restrictive visitor policies. In the event that
individuals living in group facilities are infected, government planners must
address how to provide care for those individuals without risking others.
Placement of individuals with disabilities, caregivers or service providers
must not leave individuals with disabilities without the supports needed to
maintain their health and safety.
Connecticut
Executive Order No. 7A grants the
Commissioner of Public Health the ability to issue “orders restricting
entrance into nursing home facilities, residential care homes or chronic
disease hospitals that she deems necessary to protect the health and welfare of
patients, residents and staff.” Oregon
Executive Order 20-10 has also increased screenings and limitations on
visitations to hospitals and surgical centers.
Mental Health
In some cases, individuals with disabilities are
pre-disposed to feelings of social isolation. Policies requiring social
distancing as a way to curb the spread
of COVID-19, may put individuals with psychosocial disabilities into greater
distress. Greater mental health services may be necessary during the
pandemic, including access to telemedicine which may be the most effective way
of administering services and practicing social distancing.
States like Rhode
Island , Arkansas
and Kansas
have expanded the availability of telemedicine to their populations. These
states have reduced barriers health services by removing the requirement of
initial in-person examinations, amongst other provisions. Expansion of
telehealth can make a significant impact on both individuals with disabilities,
as well as individuals in more rural areas who may find it difficult to access
healthcare in the first place.
Learn more
To learn more about issues facing individuals with
disabilities, read the Partnership for Inclusive Disaster Strategies National
Call to address the rights and needs of persons with disabilities
throughout all COVID-19 planning and response. The document addresses
opportunities state government’s have for improving current strategies and
calls on governments to close gaps, minimize the impact and optimize community
resources.
