HELENA, Mont. -- Montanans with disabilities face multiple barriers to care in the coronavirus pandemic, and those issues are compounded in rural parts of the state.

Fewer than a quarter of Montana counties have Intensive Care Unit beds. Lillie Grieman, project director for the Research and Training Center on Disability in Rural Communities, said that means having to travel long distances in an emergency.

For example, in Toole County, hit hard by the coronavirus, the closest ICU beds are in Great Falls, about 85 miles away.

"Not only do you have to travel far to get to beds," Grieman said, "You're going to a place where there are more people, where there is also an outbreak, and those beds may also still be in high demand. So, that's what I find particularly disconcerting."

Greiman noted that rural communities also have higher rates of people with disabilities, about 18% compared with 12% in metro areas, and the average age also skews higher in rural areas.

Montana is reporting 437 cases and a dozen deaths from COVID-19.

Disability-rights groups have raised concerns that once a person with disabilities gets to the hospital, they could be last in line if resources are scarce. Some of the crisis-care plans in states across the country ration care at their expense.

Travis Hoffman, advocacy coordinator for Summit Independent Living in Missoula, participated in a state work group on rationing care in a doomsday scenario as the virus began to spread. He said the group discussed making medical decisions based on science rather than perceived quality of life.

"Ensuring that decisions about everybody -- not just people with disabilities -- are based off of actual science and concrete medical principles," Hoffman explained, "and that if need be, people with disabilities would be granted reasonable accommodations to receive the care that they need."

The Department of Public Health and Human Services didn't respond by deadline to a request for comment on what rationing plans look like in Montana.

New York disability-rights advocates are celebrating the 34th anniversary of the passage of the Americans with Disabilities Act.

The 1990 legislation prohibits discrimination against people with physical or mental disabilities. Along with becoming a standard part of employment law, it bolsters accessibility in the public environment.

As seminal as the ADA is, said Dr. Sharon McLennon Wier, executive director of the Center for Independence of the Disabled New York, more work must be done to achieve true accessibility.

"Even though ADA has been around for many, many years," she said, "there is still ignorance regarding what is true accessibility and how new construction at times can still be put up without following the principles of ADA universal access."

Downstate New York's transportation systems lack ADA compliance. Only 31% of New York City's Subway system is accessible to people with disabilities. Funding has been allocated to make the system 95% compliant. The work would have been done by 2055, but since Gov. Kathy Hochul paused congestion pricing, these plans have been put on hold indefinitely.

A New York City Comptroller report finds only 40% of the city's disabled population is employed. Statewide reports show post-pandemic employment for people with disabilities is recovering much slower than the nation.

To change this, said McLennon Wier, classroom instructional materials need to be more accessible, "having more raised line drawings, having more Braille available, having more assistive technology that can read various types of charts and diagrams."

She said she thinks certain industries are siloed, but once they open up to better comprehend universal accessibility, more people with disabilities will join them. One place this can work is in STEM fields, as only 3% of that workforce includes people with disabilities.

July is Disability Pride Month, and today is the 34th anniversary of the signing of the Americans with Disabilities Act.

Federal data show that more than 42 million Americans have a disability affecting their cognition, mobility, hearing, vision or ability to provide self-care or live independently.

"Studies over and over demonstrate that people with disabilities are a very solid
part of our workforce," said Joe Xavier, director of the California Department of Rehabilitation, which helps people with disabilities thrive at work. "They stay in their jobs, they're committed to the work that they do, and so there's much less turnover with people with disabilities, thereby reducing the cost and all the work associated with that."

Advocates have said companies are responsible for providing accommodation in the same way they provide chairs and technology for all their workers. They encourage companies to follow principles of universal design when building new spaces, so access is not an afterthought.

Britanny Comegna, a member of the State Rehabilitation Council, runs a company called Deaf and Disability Mediation Services and said people shouldn't be shy about direct communication with disabled people.

"When you meet a new disabled person," she said, "you have to ask, 'How do you want to identify? What do you need? And what can I learn from you?' Ask those questions because we really do appreciate that you're making that effort to connect with me and understand me as a person."

The Centers for Disease Control and Prevention is working to reduce health disparities among adults with disabilities, who have higher rates of smoking, obesity, heart disease and diabetes.


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Advocates for individuals with disabilities want the state of Nevada to further embrace what is known as the "independent living" model.

Dawn Lyons, executive director of the Nevada Statewide Independent Living Council, said the philosophy is centered around people with disabilities being their own experts on their needs and the services they require. Lyons acknowledged within the state's disability community, there exists what she called "inter-conflict," leading to a lack of a unified voice and sending mixed signals to policymakers.

"Even though we have these other voices interfering, saying different things, what it comes down to is 'We don't need to fight each other,'" Lyons emphasized. "I think the reason why we end up with that inter-conflict is because we've been put down so often and we've been told that we don't matter."

Lyons has been with the council for the last eight years and pointed out progress has been made but more needs to be done. She argued education related to independent living is key to moving the needle and the council supports developing educational materials as well as consulting with a state currently employing an effective independent living approach. Lyons explained one of those states could be Colorado, which she adds even has its own independent living agency.

John Rosenlund, program director for the Nevada Assistive Technology Collaborative, said independent living boils down to empowerment. He said he recognizes the state cannot move forward with implementing a philosophy if there are those who do not agree with it or are comfortable with the status quo.

Rosenlund contends centers for independent living across the state have strayed from independent living values such as peer support, individual and systems advocacy and independent living skills training.

"Things aren't right, they've lost the meaning of what independent living is, perhaps," Rosenlund suggested. "Or they're too focused on certain things so that stability at centers for independent living is, in my mind, instrumental."

Rosenlund added the lack of awareness and adoption of independent living's core values is having real effects across the state, with some missing out on real opportunities to enhance their lives. He reminded people without any change or challenge, there will not be any growth.