Over time, new implications and applications for the Americans with Disabilities Act have emerged. The act addresses nondiscrimination with regard to public services and public facilities, but does not specifically mention natural disasters or other emergency situations. The implications for these situations, however, have become evident, especially as more focus has been placed on emergency preparedness in the wake of the September 11, 2001, terrorist attacks and numerous natural disasters. The Department of Homeland Security (DHS) and the National Council on Disability have issued recommendations on emergency preparation. Congress and individual states have written legislation to address these needs. In July 2004, President George W. Bush established the Interagency Coordinating Council on Emergency Preparedness and Individuals with Disabilities.

The purpose of the council is to:

Meeting the needs of people with disabilities during disasters includes planning for medical care, transportation, communication, and other special needs. © AP Images/Bill Ross

• consider, in their emergency preparedness planning, the unique needs of agency employees with disabilities and individuals with disabilities whom the agency serves;

• encourage, including through the provision of technical assistance, consideration of the unique needs of employees and individuals with disabilities served by state, local, and tribal governments, private organizations, and individuals in emergency preparedness planning;

• facilitate cooperation among federal, state, local, and tribal governments, private organizations, and individuals in the implementation of emergency preparedness plans as they relate to individuals with disabilities.

In April 2006, Daniel W. Sutherland, chair of the Interagency Coordinating Council, spoke to attendees at the National Hurricane Conference on how to integrate individuals with disabilities into the emergency management process. Learning lessons from the hurricanes of 2005, he said:

The needs and talents of people with disabilities must be more effectively integrated throughout the emergency management process. While all Americans face difficulties during emergencies, these difficulties are often compounded for people with disabilities and their families. This is not a "niche" issue, worthy of a footnote or two as we discuss the lessons learned from [Hurricane] Katrina. Ö [T]he disability community constituted approximately 20 percent of the people who lived in the Gulf Coast region. These are complex issues, affecting a large number of people, and we must do a more effective job in addressing them. Ö We recognize that state and local governments are the primary first responders in a disaster. Ö Our role and responsibility is not to add new burdens to your work, but to identify ways that we can help you effectively deal with the complex and unique issues in this arena. Ö People with disabilities do not want to be passive consumers of help. Rather, people with disabilities have a tremendous amount to offer because they bring a unique blend of energy, experience, ideas, and determination to these issues. People with disabilities, their families, and the organizations that serve them want to help; all you have to do is enlist them in the service.

The full text of Sutherland's remarks can be found at http://www.dhs.gov/xabout/structure/editorial_0842.shtm.

While the Department of State's primary mission is the conduct of U.S. foreign policy, it also is involved in disability issues. In addition to the normal concerns about accommodating the needs of employees and their families, who are assigned throughout the world, American embassies and consulates provide services to U.S. citizens living or traveling in host countries. A consular office in France, for example, was asked by an American deaf woman to help explain the role of a service dog to local officials, who were familiar with dogs for the blind but were unfamiliar with a dog serving a hearing-impaired owner.

The State Department also sponsors cultural and educational programs dealing with the subject of disability. A number of programs and exchanges reach out to students with disabilities, including two that send U.S. teachers or student interns to work with programs for the deaf in other countries. Other programs may not focus exclusively on audiences with disabilities, but may have some connection with special needs audiences. World Cup athletes recently visited several countries and met with many groups, including deaf footballers from Bahrain's Disabled Sports Federation—a program that resulted in extensive local press interest in Bahrain and promises to lead to follow-up activities.

Another State Department office recruits and sends U.S. citizens as experts to conduct programs around the world. These programs sometimes involve unusual requirements, such as the need to send along a sign language interpreter when a hearing-impaired disability expert traveled to do programs in Shanghai or the special arrangements needed when a blind speaker visited India with her seeing-eye dog. In the United States, it is not uncommon to see service dogs working with blind, deaf, or otherwise disabled people, and "therapy" dogs even visit hospitals and nursing homes to help calm patients (research shows that the presence of these dogs improves blood pressure and pain tolerance and helps reduce depression). Making arrangements for people and their service animals to visit other countries where the regulations and cultures are different, however, presents special challenges for program organizers. But it is well worth the extra effort, when the result is not only that the department's human emissaries have the support needed to do their work in another country, but, as in the case in India, the speaker's dog became a bit of a media sensation herself, introducing a large segment of the population to a new concept.

To read an article about the experiences of Joyce Kane and her dog during their programs in India, go to http://usinfo.state.gov/scv/Archive/2005/Jul/18-456527.html.

To learn more about international programs for the deaf, visit

Global Deaf Connection at http://www.deafconnection.org and

The International Deaf Partnerships Project at

http://academic.gallaudet.edu/courses/spa/CREPBerw.nsf.

Many government and nongovernmental programs, centers of study, publications, and research reports address issues related to disabilities and technological advances that help mitigate them. Disability-related projects involve everything from face-to-face and long-distance communication to mobility, from learning aids to robotics for the workplace. The projects currently underway and new advances recently announced are too numerous to recount in one article, or even an entire journal. One project that illustrates the kind of practical innovation that is going on is being funded by an "Innovation Grant" from the Burton Blatt Institute (BBI) of Syracuse University in New York. Led by a faculty member of the university's School of Information Studies, the project also involves hospitals around the state.

Internet Video Interpreting for Remote American Sign Language (ASL) Services

Imagine. You cannot hear, and you cannot speak without sign language. You bring your injured child into the emergency room at the hospital. No one can explain to you what is happening, what you are supposed to do, and what you can expect. Your concern is escalating, and the doctors need information you cannot provide. What can you do?

In New York, recent amendments to the state's Official Compilation of Codes, Rules, and Regulations require health care facilities to make language assistance services available to "patients in the inpatient and outpatient setting within 20 minutes and to patients in the emergency service within 10 minutes of a request" for such services, whether the language is Chinese or American Sign Language (ASL). Health care facilities in Syracuse and elsewhere in the state of New York are actively exploring ways to comply with this new stipulation. Video-delivered ASL services, where the interpreter makes a "house call" to the facility from a remote location over the Internet, is an innovative option under serious consideration. The Internet promises an entirely new capacity to broaden social inclusion, and ASL services of significant interest include interpreting, mental health counseling, and emergency preparedness and disaster response.

In Phase 1 of the BBI Innovation Grant research project, three research sites, all located in the city of Syracuse, are exploring ASL via the Internet. Two of the sites are hospitals that use ASL services, and the third is a nonprofit provider of such services. Research questions of interest include: What ASL services are provided and used today? What new opportunities and challenges stem from Internet-delivery of ASL services? While there are exciting new business and service opportunities from Internet delivery, there are also challenges that must be overcome before Internet-delivered ASL services become commonplace. One likely source of challenge is compliance with HIPAA (privacy regulations regarding health information that put strong requirements on medical offices to protect patient medical information). In Phase 2 of the project, health care facilities in a 14-county area in New York will be surveyed on their readiness for complying with the new stipulations on access to ASL services and on prospects for adopting Internet-delivered ASL services.

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