As testimony continues in the 2013 Boston Marathon bombing case, memories of that day are still fresh in many people’s minds – especially for the 16 people who lost limbs on that tragic day. By law, every jurisdiction must have plans and partnerships in place to ensure that those with existing or newly acquired disabilities are properly cared for in any emergency.
According to 2010 U.S. Census estimates, 56.7 million Americans – or, approximately one in five – live with disabilities. Analysts, such as the Population Reference Bureau, expect this number to rise as the baby-boomer population ages. People may experience physical disabilities (using wheelchairs or special equipment for mobility), cognitive disabilities (difficulty learning/remembering), intellectual disabilities (such as Down syndrome), and sensory disabilities (such as deafness or blindness). Emergency planners and responders must account for all of the different types of disabilities that members of their community experience at any point in time. Planning and response efforts must account for those who have existing disabilities or impairments, as well as for those with newly acquired disabilities as a result of an emergency or disaster – for example, an amputation or traumatic brain injury caused by an explosive device.
As part of their preparedness planning efforts, local health departments must adhere to the Centers for Disease Control and Prevention’s Public Health Emergency Preparedness Capabilities. In a 2014 nationally representative survey of local health departments, approximately 70 percent of those surveyed reported including people with disabilities in their emergency preparedness planning and response efforts. Even though findings from this National Association of County and City Health Officials (NACCHO) survey suggest that local health departments are more likely to include people with disabilities in emergency preparedness planning and response efforts than any other type of program, there is still room for improvement. Emergency planning for people with disabilities is the law. The purpose of this article is to provide a general overview of the legal aspects of preparedness planning for people with disabilities and raise awareness about the importance of community partnerships when planning for emergencies and disasters.
The Law – Accessibility & Discrimination Concerns
According to the Americans with Disabilities Act Title II Regulations: Part 35 Nondiscrimination on the Basis of Disability in State and Local Government Services, emergency planners must ensure that emergency plans and response efforts provide: (a) physical access; (b) programmatic access; and (c) effective communication for people with disabilities. In essence, the law states that everyone must be given equal access to emergency services and emergency communications. When planning for people with disabilities, it is important to note that “accessibility” for one person does not necessarily mean “accessibility” for another. At a shelter, for instance, the concept of accessibility for a person who uses a wheelchair may mean having an entrance ramp, but it may mean having large-print or audio-communication materials available for someone with vision impairment.
There have been a number court cases over the past few years that called attention to the importance of including people with disabilities in emergency response efforts. In 2011, a California court ruled that the city and county of Los Angeles was discriminatory because that jurisdiction did not have a plan in place to notify, evacuate, or provide transportation for people with disabilities in the event of a disaster. As a result of this lawsuit, Los Angeles was ordered to coordinate with organizations: (a) to ensure that necessary sheltering resources would be accessible to all people in a disaster; (b) to provide accessible communication and transportation; and (c) to plan for continuity of care services for people with disabilities.
In 2013, the U.S. District Court, Southern District of New York, ruled that the City of New York discriminated against people with disabilities by failing to plan for their needs in disasters such as Hurricane Sandy. This ruling specifically noted a failure to provide information about the existence and location of accessible services during an emergency. More recently, in September 2014, disability rights activists filed a complaint against the District of Columbia stating that the jurisdiction did not specifically include residents, commuters, or tourists with disabilities in emergency response plans (a ruling has not yet been made in this case).
Trusted Sources, Valuable Resources & Community Partnerships
NACCHO has found that one of the most effective strategies for emergency preparedness planning and response at the local level is for health departments to establish and maintain close partnerships with community members and community-based organizations representing the interests of people with disabilities. Consistent with the decades-old disability rights adage, “Nothing about us without us,” NACCHO recommends that emergency planners reach out to community members with disabilities and invite them to participate in planning meetings and exercises in order to test already-existing response plans.
In addition, NACCHO also emphasizes the importance of building strong partnerships with community-based organizations – for example, The Arc, Centers on Independent Living, Easter Seals, Meals on Wheels, Special Olympics, Goodwill, Family Voices. These community-based organizations are trusted sources within the disability community and often best know the location and needs of their members with disabilities. Involving these community-based organizations as well as people with disabilities in all phases of preparedness planning and response assists emergency planners in tailoring plans to meet their communities’ specific needs. This in turn ensures that all people have equal access to resources during an emergency or disaster.
In order to help local health department emergency planners better integrate community members’ needs in their preparedness response plans, NACCHO developed two resource guides. The first, Strategies for Successfully Including People with Disabilities in Health Department Programs, Plans, and Services, provides basic action steps that health departments can take to become more inclusive in health promotion and emergency preparedness programs and plans. The second, Directory of Community-Based Organizations Serving People with Disabilities, provides a list of community-based organizations that health departments should consider partnering with in order to better include people with disabilities in emergency preparedness planning and response. NACCHO also offers one-on-one technical assistance to health departments that are interested in learning how to better include people with disabilities in response plans.
As mentioned throughout this article, the population of people with disabilities must be considered in all aspects of emergency preparedness planning and response. Localities may experience legal ramifications for not carefully including people with disabilities in their emergency planning and response efforts. One of the best ways for local health departments to start including people with disabilities is to reach out to these community members and community organizations.
Kendall A. Leser
Kendall A. Leser, M.S., is a program analyst with the National Association of County and City Health Officials’ Health and Disability and Public Health Law programs. She also is a Ph.D. candidate at The Ohio State University’s College of Public Health, where she is finishing her doctoral dissertation research on the health of people with intellectual and developmental disabilities and their caregivers. She has nearly eight years of experience in the field of health and disability, where she has provided direct care support services to people with disabilities, as well as worked on various research and community projects related to promoting the health and wellbeing of people with disabilities.