Integrating Mental Health and Disability Into Public Health Disaster Preparedness and Response - Chapter 7 - Legal issues related to emergencies and disasters

Antidiscrimination and other selected issues

Elsevier, Integrating Mental Health and Disability Into Public Health Disaster Preparedness and Response, 2022, Pages 147-169
Katherine Snyder, Susan Wolf-Fordham

This chapter focuses on civil rights issues related to emergencies, disasters and pandemics. The chapter begins with a discussion of the Americans with Disabilities Act of 1990 (ADA) and Section 504 of the Rehabilitation Act of 1973 (Section 504) which prohibit disability discrimination broadly, including in relation to emergencies. The chapter summarizes the legal requirements that disabled people have “physical access,” “program access” and “effective communication” (including “auxiliary aids and services”), in the “most integrated setting,” with “reasonable modifications” (accommodations) as needed. Despite strong anti-discrimination laws, there have been persistent, well-documented challenges to achieving legal compliance. Since there is no one list of all possible reasonable modifications, the chapter shares examples of potential compliance solutions derived from court decisions, legal settlements, and a US Department of Justice compliance programs. The chapter then touches on the issue of equity when modifying usual healthcare standards, a topic of discussion during the COVID-19 pandemic and other times where there is concern about potentially scarce medical resources. People with disabilities may identify as members of more than one historically marginalized group, so the chapter summarizes civil rights laws applicable to populations other than people with disabilities, such as racial and ethnic minorities. Some erroneously assume that any law can be waived (temporarily suspended) in an emergency, but this is not necessarily the case. This chapter concludes with a discussion about emergency waivers using the HIPAA (Health Insurance Portability and Accountability Act) privacy and health information security law and civil rights laws as examples.