Tailoring Disaster and Public Health Emergency Preparedness, Response, and Recovery to the Needs of Older Adults and Disabled Americans

Transcript

Mahshid Abir, Senior Physician Policy Researcher, RAND Corporation

On a typical day in the emergency department, many older adults and individuals with chronic diseases present for care. Many of these patients have multiple comorbidities and long lists of medications, and some are dependent on life-sustaining medical devices.

During emergencies, these populations' challenges in seeking health care are compounded by the uncertainties presented by these events. Disruptions in access to food, shelter, transportation, electricity, health services and medications can put older adults and people with disabilities in an even more vulnerable position. Any one of these disruptions can lead to acute exacerbations of chronic illnesses and the need for care in the emergency department and inpatient settings.

In order to effectively plan for the response and recovery needs of older adults and people with disabilities, a data driven approach and leveraging technology is imperative. We really have kind of not explicitly focused on these populations and we have not done it in a data driven way. And I think that the best opportunity now is the hindsight of looking at the pandemic because it did affect these populations the most and we now, unfortunately, have plenty of data to look back at.

Beyond leveraging data and technology, Congress could take steps to advance the health and safety of older adults and people with disabilities in emergency contexts, such as requiring Medicaid payments to be made out-of-state for older adults and people with disabilities during public health emergencies and disasters; extending Medicare's 20-percent increase for inpatient COVID-19 Care to all Medicare-eligible adults and people with disabilities during future incidents; requiring the development of resources and capabilities within public health departments to address the needs of older adults and people with disabilities.

Given that preparedness, response and recovery is likely most challenging in the context of these groups because of the intensity of their health care and social services needs, framing related policies and practices based on them are likely to improve the processes for all Americans.