Centering the Disability and Aging Communities in Federal Emergency Response Efforts
As the United States continues to grapple with the ongoing devastation of the coronavirus pandemic, it will also soon face extreme seasonal weather. From fires in the Southwest and the West to weather vortexes and floods in the Midwest to hurricane season in the South and the Southeast, the United States must prepare for upcoming disasters within the context of a global pandemic. Powerful hurricanes, heavy downpours, flooding, intense heat waves, and other extreme weather emergencies can endanger public health and safety, cause widespread damage, and make social distancing and stay-at-home orders impossible to implement. As shown throughout the COVID-19 response, older people and people with disabilities often feel the disproportionate effects of poorly handled national preparedness efforts. Unfortunately, these individuals have often been excluded from response strategies and emergency management at the federal level, despite comprising more than 25 percent of the U.S. population.
The Real Emergency Access for Aging and Disability Inclusion (REAADI) for Disasters Act and the Disaster Relief Medicaid Act (DRMA)—two federal bills written with direct input from the disability community—are long-overdue opportunities to center disabled and older people in federal disaster response strategies.
Disabled and older people have historically borne the brunt of disasters
People with disabilities and older adults regularly average higher death and injury tolls in emergency situations yet find themselves at the mercy of volunteer and government responses that are unprepared, inaccessible, and often noncompliant with federal accessibility standards. For example, disabled people and older adults made up 77 percent of Camp Fire victims in Paradise, California; nearly 50 percent of Superstorm Sandy victims; and approximately 71 percent of Hurricane Katrina victims. Similarly, preparedness efforts fail other groups such as indigenous, Black, detained, and low-income communities, all of whom feel the disproportionate effects of inadequate planning and inclusion. While not an extreme weather event, the coronavirus pandemic has resulted in the same pattern of disproportionate devastation, with Black people in particular dying at more than two times the rate of white people.
In addition to the strain on resources exacerbated by the coronavirus, the Federal Emergency Management Agency (FEMA) has failed to ensure that funds are spent in a way that addresses the needs of people with disabilities and allows for an inclusive community recovery in the event of extreme weather. In fact, in 2018, FEMA decided to deploy fewer qualified disability specialists to disaster areas, cutting the number from 65 experts deployed to a single disaster area to five; these experts now work exclusively by phone rather than in the field. Furthermore, certain grants and partnerships for the mitigation and rebuilding process suggest—but do not require—disability coordinator professionals. This lack of requirement risks federal funds being used in programs, buildings, housing, or other efforts that do not meet accessibility requirements established through legislation, including the Americans with Disabilities Act.
In a time of global emergency, those in nursing homes and congregate living spaces are paying the toll for deregulation and unsafe living conditions—and the nursing home industry is lobbying to not be held accountable. According to the AARP, 19 states have currently issued executive orders or laws that give nursing homes legal immunity for harm or death due to the pandemic. The industry is now pushing for this immunity to be federal. Meanwhile, more than 40 percent of COVID-19 deaths nationwide have happened in nursing homes. People with disabilities must provide needed expertise in navigating disaster impacts on disabled lives.
The REAADI for Disasters Act and DRMA prioritize the needs of the disability and aging communities
Introduced last June, the Real Emergency Access for Aging and Disability Inclusion (REAADI) for Disasters Act seeks to include people with disabilities and older adults in conversations about disaster preparedness. If passed, the bill would lead to increased investment in disaster research and technical assistance as well as reviews of FEMA spending and accessibility compliance. It allocates funding to focus on gaps in response efforts for the aging and disability communities. Moreover, it creates coalitions seated primarily by people with disabilities and older adults to inform recommendations on best practices. The REAADI for Disasters Act also requires a review of federal response efforts and federal agencies’ compliance with disability discrimination policies.
As extreme weather events increase in frequency, impact, and duration, the REAADI for Disasters Act is a strong first step toward better preparing for, responding to, recovering from, and creating resilience around these events. It is past time to dedicate resources to fixing the gaps in practices that continually allow disabled people and older adults to be fatally injured, left behind, and displaced at disproportionate rates.
A second bill introduced, the Disaster Relief Medicaid Act (DRMA), establishes an individual’s right to access health care regardless of where in the country they might end up as the result of a disaster event. Specifically, DRMA allows for Medicaid portability across state lines. For context, Medicaid covers roughly 65 million U.S. residents, including children, pregnant individuals, seniors, and people with disabilities.
How these bills complement and build on COVID-19 response efforts
The United States has already begun to experience the danger of concurrent disaster events. For example, a deadly tornado hit Nashville, Tennessee, in early March—just 10 days before the United States declared a national emergency due to COVID-19—leaving 24 people dead and nearly 47,000 more without power. Additionally, in the three months since social distancing measures were put in place, a polar vortex hit the Northeast; earthquakes occurred in the West, including a 6.5 magnitude quake that hit Nevada earlier this month; and a massive flood in Michigan caused the evacuation of more than 10,000 people. Bills such as REAADI and DRMA not only would lead to better support during these concurrent disaster events, they would also complement provisions in existing COVID-19 response efforts. The Families First Coronavirus Response Act, for example, increased the federal Medicaid matching amount and required states to meet maintenance-of-effort requirements in order to receive these increases—meaning that states cannot implement new eligibility guidelines that remove people from the program during the coronavirus crisis. Moreover, pending legislation, such as the Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act, would further bolster federal support for the Medicaid program.
The disability and aging communities have spent years fighting for a seat at the table, rallying around a common phrase: “Nothing about us without us.” The REAADI for Disasters Act and DRMA are comprehensive efforts to finally put that mantra into action when it comes to emergency management.
Ultimately, both pieces of legislation are bold in their simplicity: Engage people with intimate knowledge of disability issues in federal preparedness, response, and recovery efforts—and make sure that people have access to health care during disaster events. These bills are necessary steps at the federal level to correct practices that have continually allowed disabled people and seniors to be fatally injured, left behind, and displaced at disproportionate rates. They also open the door to allow people with various lived experiences—whether based on race, age, income, or ability—to be part of the solution and improve outcomes for everyone in a time when it is sorely needed.
Bills such as the REAADI for Disasters Act and DRMA are a testament to the power of bringing disabled and older adults to the table, where they have always belonged. While preparedness professionals and legislators cannot always predict the total effect of disaster events such as COVID-19, there is no question that extreme weather events will occur. It is the duty of those in these positions to ensure that all communities are adequately prepared, and it is impossible to do so without their input.
Valerie Novack is a fellow with the Disability Justice Initiative at the Center for American Progress.
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