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- Ensuring Equity and Inclusion

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            -                   Ensuring Equity and Inclusion              

# Ensuring Equity and Inclusion

## Guidance from other federal programs

                  - Statement by the U.S. Principal Deputy Assistant Attorney General for Civil Rights Leading a Coordinated Civil Rights Response to Coronavirus (COVID-19)
                  -  U.S. Principal Deputy Assistant Attorney General for Civil Rights Pamela S. Karlan issued a statement and resource guide to assist federal agencies, state and local governments, and recipients of Federal financial assistance in addressing ongoing civil rights challenges related to the COVID-19 pandemic. 
                  - U.S. Equal Employment Opportunity Commission Technical Assistance
                  -  The U.S. Equal Employment Opportunity Commission (EEOC) posted updated and expanded technical assistance related to the COVID-19 pandemic, addressing questions arising under the federal equal employment opportunity (EEO) laws. The EEOC also posted a new resource for job applicants and employees, explaining how federal employment discrimination laws protect workers during the pandemic. These publications are provided to help employees and employers understand their rights and responsibilities at work during the pandemic.	The expanded technical assistance provides new information about how the Americans with Disabilities Act (ADA) and the Genetic Information Nondiscrimination Act (GINA) apply when an employer offers incentives for employees to provide documentation or other confirmation of vaccination when an employee gets a vaccine in the community or from the employer or its agent. 
                  - Purchase/distribution of food as an Emergency Protective Measure under FEMA's Public Assistance Program  
                  -  Extensions now allowed for the duration of the COVID-19 public health emergency  On April 12, 2020 FEMA released a policy that authorized purchase and distribution of food as an Emergency Protective Measure. Under that policy, applicants could receive funding for an initial 30-day period and could request one 30-day extension. Depending on the time period for applicants requested reimbursement, eligibility under this policy for the initial 60 days could end as soon as May 13, 2020.  This policy was intended to allow FEMA to meet immediate needs, until other federal programs/funding became available. However, for a variety of reasons, including scale of need, it is likely that other federal programs will not be able to meet the needs of individuals coping with COVID-related food insecurity within the initial timeframe.  Therefore, Public Assistance has clarified that extensions beyond the initial 60 days are allowable (in increments of 30 days or fewer per extension) for the duration of the COVID-19 Public Health Emergency, if necessary.    The State, local, tribal, and territorial (SLTT) government entities should collaborate with government stakeholders including ACL, state units on aging, area agencies on aging , regional and local Housing and Urban Development Public Housing Authority (HUD/PHA), and USDA Food and Nutrition Service to understand what they are doing to address these needs and communicate assistance requirements.  The SLTT should also collaborate with non-governmental organizations including volunteer organizations, senior centers and adult day care, and service/volunteer organizations including Meals on Wheels, the Salvation Army, the American Red Cross, faith-based communities, and other organizations. Identify resources that might be applied or redirected to close gaps.  All efforts should be made to prioritize the most vulnerable populations, then register those needing assistance into these more traditional nutrition assistance programs, thereby further stabilizing the situation and ensuring FEMA eligibility.  Refer to these resources from the FEMA/HHS Community Mitigation Task Force: Sustaining Nutritional Needs for At-Risk Individuals and Information on Federal Programs to Sustain Nutrition for At-Risk Individuals   While FEMA is coordinating with other partners to determine the appropriate level and source of support moving forward, it is very important that the SLTT work on transition plans that may be needed beyond additional extensions.    **FEMA's Public Assistance Program** supports communities’ recovery from major disasters by providing them with grant assistance for debris removal, life-saving emergency protective measures, and restoring public infrastructure. Under the President’s emergency declaration and subsequent major disaster declarations for COVID-19, state, local, tribal, and territorial government entities and certain private non-profit organizations are eligible to apply for assistance under the FEMA Public Assistance Program. 
                  - Assistance for Small Businesses (Includes non-profits)
                  -  Assistance for Small Businesses:  The Paycheck Protection Program ensures that small businesses can continue to pay employees and cover costs during this unprecedented health crisis. For up to eight weeks, this program can be used to cover the entire cost of payroll and other eligible expenses.  **Private non-profit organizations are eligible for the Paycheck Protection Program.**  **UPDATE**: As of Wednesday, February 24, 2021 at 9 am ET, the U.S. Small Business Administration (SBA) established a **14-day**, exclusive PPP loan application period****for businesses and nonprofits with fewer than 20 employees.  Resources from the Department of the Treasury:                      - Information for Borrowers
                    - Frequently Asked Questions
                    - Application for Borrowers  Learn about other programs for small businesses. 
                  - CMS Guidance and Information:  Includes Nursing Homes Best Practices Toolkit,  telehealth flexibilities, HCBS waivers, nursing home visitation, & more 
                  -                      -  The Centers for Medicare and Medicaid Services released a Fact Sheet with information about the 2021 Special Enrollment Period for Marketplace Coverage on HealthCare.gov, which began on 15 February 2021. To read the CMS press release, click HERE. 
                    -  The CMS Center for Clinical Standards and Quality/Quality Safety & Oversight Group has provided a holiday notice to Nursing Homes, Residents, and Resident Family Member(s)/Representative(s). CMS is urging nursing home staff, residents and visitors to follow established guidelines for visitation and adherence to the core principles of infection prevention. CMS is recommending that facilities find innovative ways of celebrating the holidays without having parties or gatherings that could increase the risk of COVID-19 transmission (e.g., virtual parties or visits, provide seasonal music, movies, decorations, etc.).  
                    -  Toolkit on State Actions to Mitigate COVID-19 Prevalence in Nursing Homes.  Developed to aid nursing homes, governors, states, departments of health, and other agencies provide oversight and assistance to these facilities, with additional resources to aid in the fight against COVID-19 pandemic within nursing homes. It includes best practices from a variety of front line health care providers, governors’ COVID-19 task forces, associations and other organizations, and experts, and is intended to serve as a catalog of resources dedicated to addressing the specific challenges facing nursing homes.                         -  Press Release (May 13)    
                    -  The Department of Health and Human Services has expanded telehealth access to combat COVID-19. For example:                        - Medicare beneficiaries can receive a  wider range of services through telehealth . See the  CMS press release  and  FAQ  for more information.
                      - A covered health care  provider also may use any non-public facing remote communication product  that is available to communicate with patients. The HHS Office of Civil Rights will exercise its enforcement discretion and will not impose penalties for noncompliance with the regulatory requirements under the HIPAA Rules against covered health care providers in connection with the good faith provision of telehealth during the COVID-19 nationwide public health emergency. Details can be found in the OCR  press release  and this  OCR bulletin .
                      - The HHS Office of Inspector General provided flexibility for healthcare providers to  reduce or waive beneficiary cost-sharing for telehealth visits  paid by federal healthcare programs. See the  OIG policy statement  for more information.
                      - CMS has created an  electronic toolkit  regarding telehealth and telemedicine for long-term care facilities. The toolkit includes electronic links to reliable sources of information regarding telehealth and telemedicine and information on choosing telemedicine vendors, equipment, and software; initiating a telemedicine program; monitoring patients remotely; and developing documentation tools. There is also information that will be useful for providers who intend to care for patients through electronic virtual services that may be temporarily used during the COVID-19 pandemic.
                      - Medicaid Telemedicine webpage  (March 19, 2020)
                      - Medicaid State Plan Fee-for-Service Payments for Services Delivered Via Telehealth  (March 19, 2020) 
                    -  CMS's COVID-19 web page includes a variety of resources for the networks:                        - CMS'  Guidance for Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19) in nursing homes  includes updated guidance for visitation. 
                      - Home and Community-Based Services 1915(c) Waiver Information
                      - The Centers for Medicare & Medicaid Services (CMS) is taking action to protect the health and safety of our nation’s patients and providers in the wake of the 2019 Coronavirus (COVID-19) outbreak. CMS has released a  Virtual Toolkit  to help you stay up-to-date on CMS materials available on COVID-19.
                      - FAQ for State Medicaid and Children’s Health Insurance Program (CHIP) Agencies  (May 5, 2020).   
                    - CMS released  guidance for states and local officials to ensure safe reopening of nursing homes  across the country. The guidance details critical steps nursing homes and communities should take prior to relaxing restrictions implemented to prevent the spread of coronavirus disease 2019 (COVID-19), including rigorous infection prevention and control, adequate testing, and surveillance.
                    - The  CMS Emergency Preparedness and Response Operations page  has links to a variety of resources related to COVID-19. 
                    - On May 22,  HHS began distributing nearly $5 billion  to help nursing homes combat COVID-19.
                    - On June 19 CMS released the  List of Members  for the independent Coronavirus Commission on Safety and Quality in Nursing Homes. 
                  - ASPR Resources for Community-Based Organizations
                  -  As the nation adjusts physical and social distancing practices, the risk and impact of the COVID-19 pandemic will remain high for many at-risk individuals, particularly those with access and functional needs. COVID-19 is likely to continue to disrupt the lives of these individuals, many of whom rely on social services and home and community-based services. Community-Based Organizations (CBOs) play an essential role in helping these individuals obtain critical services and supports allowing them to adjust to the COVID-19 era.  The HHS Office of the Assistant Secretary for Preparedness and Response has created a new resource page providing information for community-based organizations during the COVID-19 pandemic. Resources focus on equipping CBOs to return to work, supporting clients and family caregiving networks, bringing innovation to CBO service, and improving integration. A resource tool is also available for Discharge Planning and Care Coordination during the COVID-19 Pandemic. 
                  - Nutrition Resources for Tribal Leaders
                  -  The Administration for Children and Families has released "Tribal Food Security Resources: A Guide for Tribal Leaders during the COVID-19 Pandemic & Recovery Period." 

## More Resources 

                  - First Responders
                  -  Tips for First Responders, developed by the University of New Mexico, Center for Development and Disability, the American Association on Health and Disability, and other partners, offers quick, easy-to-use procedures for assisting people with disabilities in an emergency. The guide includes specific tips to support:                      - Seniors
                    - People with service animals
                    - People with mobility impairments
                    - People with Autism
                    - People who are deaf or hard of hearing
                    - People who are blind or visually impaired
                    - People with cognitive disabilities
                    - People with multiple chemical sensitivities
                    - People who are mentally ill
                    - Childbearing women and newborns
                    - People With Seizure Disorders 
                  - Telehealth for Deaf and Hard-of-Hearing People
                  -  A coalition of deaf and hard of hearing consumer advocacy organizations, deaf healthcare providers, and other experts worked together to provide these guidelines for healthcare providers. 
                  - Disaster Preparedness During COVD-19 Crisis
                  -  Healthcare System Preparedness for Secondary Disasters during COVID-19. Secondary disasters (e.g., natural disasters, cyberattacks, large-scale transportation accidents, mass casualty incidents) that strike during the COVID-19 pandemic will further stress the health and medical system and threaten vulnerable residents and infrastructure. Below are considerations for healthcare and emergency management professionals when planning for allhazard secondary disasters during a public health emergency.  The National Governors Association (NGA) released guidance on managing natural disasters during pandemics. The NGA notes that responding to and recovering from natural disasters presents a significant challenge to states, notwithstanding the impacts of COVID-19 on human, financial, and physical resources. Their document was created for the nation's governors, but contains information that is broadly useful.  AT3 Center has hurricane preparedness tips for users of assistive technology (AT) HERE.  FEMA has issued an interim policy titled Emergency Non-Congregate Sheltering during the COVID-19 Public Health Emergency  The policy defines the framework, policy details, and requirements for determining eligible work and costs for non-congregate sheltering in response to a presidentially declared emergency or major disaster, or Fire Management Assistance Grant (FMAG) declaration (Stafford Act declarations).  The American Red Cross has a site dedicated to Preparing for Disaster During COVID-19. The Red Cross advises that, during the COVID-19 crisis, we must prepare a little differently for disasters that may affect our communities. 
                  - Study Highlights Need to Include People with Disabilities in Pandemic Responses
                  -  The results of a March 2021 study, titled "New obstacles and widening gaps: A qualitative study of the effects of the COVID-19 pandemic on U.S. adults with disabilities" states that the COVID-19 pandemic unequally impacts people with disabilities. The study participants indicated that to fully address their needs, disability perspectives must be included in the public health pandemic response. 
                  - Strategies to Increase Vaccine Access
                  -  "Strategies for Helping Older Adults and People with Disabilities Access COVID-19 Vaccines" is a document developed by ACL that offers examples and promising practices for states, municipalities, community-based partners, and anyone else working to ensure that older adults and people with disabilities can get vaccinated for COVID-19. 
                  - Health Equity and People with Disabilities Infographics
                  -  The National Institute for Health Care Management (NIHCM) has developed a number of infographics highlighting disparities in how the COVID-19 pandemic has impacted people with disabilities and strategies to promote health equity.  

## American Sign Language

CDC COVID-19 resources are now available in American Sign Language via YouTube. You can see the entire Playlist on YouTube  (24 videos, as of Feb. 8, 2021) or browse by topic:
                  - General Information
                  -                      - How does COVID-19 spread ? 
                  - Prevention  
                  -                      - COVID-19 Prevention Tips
                    - What You Need to Know About Handwashing
                    - Use of Cloth Face Coverings --Surgeon General Jerome Adams shows you how to make one 
                    - Do Your Part to Slow the Spread
                    - Social Distancing
                    - Managing Stress and Anxiety 
                  - Know your risk
                  -                      - What older adults need to know about COVID-19
                    - COVID-19: Are You At Higher Risk for Severe Illness?
                    - What is my risk for COVID-19? 
                  - Symptoms and Care
                  -                      - Symptoms of Coronavirus Disease 2019
                    - Use the Coronavirus Self Checker to help decide when to call a doctor
                    - When to Get Medical Care for COVID-19
                    - 10 Things You Can Do to Manage COVID-19 at Home
                    - Caring for Someone at Home Who May Have COVID-19 
                  - COVID-19 and Children
                  -                      - Parents Supporting Children
                    - Answering Questions from Children about COVID-19
                    - Tips to Keep Children Healthy While School is Out 
                  - COVID-19 and Pregnancy
                  -                      - What is the Risk to Pregnant Women?
                    - Can COVID-19 be passed from a pregnant woman to the fetus or newborn? 
                  - CDC Foundation Report: Maintaining Physical and Mental Well-Being of Older Adults and Their Caregivers
                  -  The CDC Foundation, with technical assistance from the Centers for Disease Control and Prevention (CDC), funded a study to examine the needs and concerns of community-dwelling older adults and caregivers during COVID-19, and the public health supports available to them. The report titled “Maintaining Physical and Mental Well-Being of Older Adults and Their Caregivers During Public Health Emergencies,” was conducted by NORC at the University of Chicago, with its partners TMNCorp and Burness. New accordion content 

The National Association of the Deaf is compiling a list of other coronavirus-related ASL videos. 

## En Español

                  - ¿Qué deben saber los adultos mayores y las personas con discapacidad?
                  - Directrices del president sobre el coronavirus para los Estados Unidos [PDF – 825 KB]
                  - CDC: Lo que necesita saber sobre la enfermedad del coronavirus 2019 (COVID-19)
                  - FDA: Preguntas más frecuentes acerca de la Enfermedad del Coronavirus 2019 (COVID-19)
                  -  Ver más 
                  -                      - CDC: Cómo protegerse
                    - CDC Guía interina: Prepare su hogar para la enfermedad del coronavirus 2019 (COVID-19)
                    - CDC: Síntomas
                    - CDC: Qué hacer si contrae la enfermedad del coronavirus 2019 (COVID-19)
                    - Información para personas con discapacidades del desarrollo :  Gracias a Green Mountain Self-Advocates !
                    - El coronavirus (COVID-19) y la parálisis  -  Gracias a  Paralysis Resource Center!                       - Hoja de datos sobre la enfermedad del coronavirus (COVID-19) 
                    -  California DD Council video series:                        -  Episodio 1 - Cómo mantenerse saludable 
                      -  Episodio 2 - Lo que debo hacer si creo que estoy enfermo 
                      -  Episodio 3 - Lo que debo hacer si estoy enfermo 
                      -  Episodio 4 - Lo que debo hacer si mi familiar o persona que me cuida se enferma 

*Last modified on 02/27/2023*

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