Development of 2021 Progress Report: COVID-19's Broadscale Impact on the Lives of People with Disabilities

Description

Notice of Funding Opportunity for a Cooperative Agreement (Not a Grant)Proposal Submission Deadline: 5:00 p.m. (submitter’s local time), August 21, 2020. Late applications will not be considered.Please visit www.ncd.gov for the full solicitation with complete requirements for submitting proposals for this funding opportunity.Project Summary The National Council on Disability (NCD) seeks proposals for a cooperative agreement to develop NCD’s annual progress report which will examine COVID-19’s broadscale impacts on the lives of people with disabilities in seven major areas: nondiscriminatory access to healthcare; the direct care workforce; group housing; education; employment; mental health; and communications. The report will also include a discussion of the intersection of disability and race, and of transportation impacts. The research and findings in this report will provide policymakers, including the White House and Congress, and federal agencies, with insight needed to make policy decisions to improve the current and future welfare of people with disabilities in a national emergency like the COVID-19 pandemic. The report will also provide people with disabilities information on federal policy, legislation, and initiatives related to emergency preparedness and response. Background and Statement of Work In 2020, the deadly COVID-19 virus swept across the U.S., having a significant, negative impact on almost every aspect of the lives of people with disabilities. By mid-March, most schools and businesses had closed, transportation was limited, and stay-at-home orders were widely in place as the nation attempted to contain the virus’ spread. By July, over 140,000 people in the U.S. had died from the virus, a large portion were people with disabilities, many of whom were compromised due to pre-existing medical conditions and many of whom lived in congregate settings like nursing homes and in group homes. For people with intellectual and developmental disabilities living in group homes, the effects have been devastating – resulting from higher susceptibility and higher deaths from the virus. COVID-19 has severely limited the ability of people with disabilities to obtain necessary services and supports to live independently, to work, to study, and to access medical care on par with non-disabled people. While natural disasters, like hurricanes Katrina and Maria, revealed the lack of a federal emergency preparedness and response plan that included evacuation and accessible sheltering for people disabilities, COVID-19 has revealed weaknesses in nearly every government and social system supporting the health, welfare, and safety of people with disabilities. These weaknesses must be the impetus for energetic planning, and implementation of policies and practices that will ensure the needs of people with disabilities are met in future pandemics.NCD has determined seven areas of focus for the development of this report: Nondiscriminatory Access to HealthcareThe pandemic struck the U.S. just months after NCD published a report series on bioethics and disability which described the discrimination that people with disabilities experience in healthcare and related services influenced by the prevalent and widespread belief by the medical profession that the life of a person with a disability has less value than the life of a non-disabled person. The more significant the disability, the more this comes into play, and the more it endangers disabled lives. The medical profession’s devaluation of disabled lives, gone largely unchecked, has resulted in historic and continuing discrimination against people disabilities as physicians and policymakers allow non-medical considerations to seep into medical decisions and healthcare policies that result in denying necessary care.The report findings were quickly validated in the early days of the pandemic. Numerous news outlets, highlighted physicians and ethicists explaining that nondiscriminatory access to healthcare was at risk. They predicted that the U.S. healthcare system lacked the capacity to provide care to every COVID-19 patient, and, people with disabilities and the elderly would likely be deprioritized for life-saving care, or denied care completely, based on their relative lack of value. As resources quickly dwindled, States began developing and revising Crisis Standards of Care - plans on which patients should receive care if rationing became necessary. Some explicitly provided that physicians should not provide care to people with certain disabilities or put them at the back of the line for care. Some state plans allowed ventilators to be taken from a person with a disability for use by a non-disabled person. These plans were discriminatory and made more shocking given that the Centers for Disease Control and Prevention reported that many people with disabilities were those most vulnerable to the virus and most likely to experience the most severe symptoms. Such plans were challenged under the ADA, Section 504 and the Affordable Care Act, through the HHS, Office for Civil Rights (OCR) and the federal courts. Further, many states provided immunity from medical liability to healthcare professionals, hospitals, long-term care facilities and intermediate care facilities. While such immunity is needed to allow healthcare providers to use their best medical judgment without fear of litigation in this unprecedented pandemic, it has given cover for the discriminatory healthcare practices reflected in the Crisis Standards of Care.Group HomesGroup homes for people with intellectual and developmental disabilities have proven to be fertile ground for the spread of the virus. Because of the easy spread between people in close contact, living in a group home makes one especially susceptible to the virus as caregivers need to be in close contact and some patient/clients may not understand the necessity to social distance. Those living in group homes are four times more likely to a contract COVID-19 than the general population, not just because of close contact with roommates and caregivers, but because are far more likely to have a preexisting health condition, such as respiratory disease, that adds to their risk. Moreover, when they contract it, they are twice as likely to die from it. The number of people who have contracted COVID-19 in group homes and who died of the virus is staggering and continues to grow. The danger has been exacerbated by the fact that direct care service workers enter the group homes daily to provide personal care assistance – close physical exposure to these workers increases the danger of residents contracting the virus due to the care workers exposure to other clients and to inadequate or lack of personal protective equipment (PPE). People with disabilities who were hospitalized for COVID-19 care or other medical issues, have also been discharged back to group homes and nursing homes – the very places where they are most at risk of exposure.Direct Care Workforce The direct care workforce has long suffered from low wages, lack of insurance and, in the pandemic thus far, a lack of PPE. Direct care workers that work in nursing and group home settings have also experienced high levels of infection, and many have stopped going to work, or reduced their shifts for fear of contracting the virus or giving it to patients/clients. This has left people with disabilities lacking the care they need. A recent Presidential Proclamation and federal laws limit immigration may decrease the amount of health aids that are available to support the disabled community and leave it vulnerable to increased complications and negatively impact independent living. EducationThe closure of educational institutions created significant hardships for students with disabilities who required special education and supports under individualized education plans or 504 plans. The move to full-time, online education created challenges for students who need in-person supports. In order to participate in classes, students who are blind, Deaf or hard of hearing or who those who have cognitive disabilities need access to accessible online learning platforms. Without supports and tools, students with disabilities cannot participate in their education on par with nondisabled peers and are at a severe educational disadvantage. Advocates have been concerned that in one of Congress’ COVID-19 relief packages, the Secretary of the Department of Education was given the authority to waive the IDEA’s civil rights requirements that ensure a free and appropriate public education - if used, such a waiver would prevent many students with disabilities from continuing their education until students return to in-person classes. Given that schools may delay reopening for quite some time, this would put students far behind their nondisabled peers. EmploymentCOVID-19 resulted in a nationwide closure of most non-essential businesses for several months. Nationwide unemployment hit all-time highs. Re-opening and re-employment hit a wall as new cases surged again in May. In previous economic downturns, employees with disabilities lose their jobs at a higher rate than nondisabled employees. COVID-19 had the same result: by May 2020, the Bureau of Labor Statistics reported that a much higher percentage of people with disabilities lost their jobs in March and April than those without disabilities. And as employers began reopening, people with disabilities were not rejoining the workforce as quickly as their nondisabled peers. People with disabilities also encountered a novel barrier to returning or starting to work: many with invisible pre-existing conditions, fearful of returning to work because of their susceptibility to the virus, lost their jobs and unemployment benefits because they were fearful of requesting an accommodation for a disability that they had not pr

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