Despite health care advances and special designations within Healthy People 2030 and NIH, people with disabilities (PWD) continue to face health disparities.1, 2, 3 Compared to people without disabilities, PWD often lack access to preventive health care services and are more likely to engage in risky health behaviors (e.g., sedentary lifestyle) due to barriers in accessing physician offices (i.e., wheelchair ramps, interpreters) and impairments potentially limiting their ability to exercise.4,5 Further, PWD face financial barriers such as employment status changes, which can alter access to health care, further increasing health disparities.6,7 Also, PWD are more likely to be overweight and obese, develop diabetes, and exhibit suicidal ideation.8,9

With the COVID-19 pandemic’s impact on physical, mental, and social well-being, health disparities disproportionately increased among PWD.10 PWD have higher risk of COVID-19 related morbidity and mortality as they are older, have lower socioeconomic status, and live with multiple chronic illnesses.11,12 Further, PWD were significantly impacted by COVID-19 response measures like quarantine, which disrupted social connections, mobility, and access to facilities and information.13,14 As PWD are more likely to experience systemic barriers including inadequate health care access, increased poverty, and lower education and employment levels, it is imperative that their needs during the COVID-19 pandemic are studied to effectively respond to future public health emergencies.12,15 While evidence demonstrates the impact of COVID-19 on PWD, the experiences of disability service providers during the pandemic remain understudied.

In the US, each state offers a variety of disability services, with many provided by non-profit organizations. The federally funded Centers for Independent Living (CILs) provide a range of services, including peer support, advocacy, and independent living skills training, which are effective in preventing development, and reducing severity, of secondary conditions from disability or impairment.16, 17, 18, 19, 20 CILs are consumer-driven, organizations that encourage independent living with a belief that all people, including PWD, can make independent choices, fully engage in society, and live with dignity.21 Since these organizations target social determinants of health, they are successful in bridging gaps in caring for PWD.22 Further, CILs are required to hire PWD as staff, allowing those with lived experiences to make decisions on activities to increase independence, thereby providing better services and reducing disparities.21,23.24 Despite their dual status as PWD and staff, who provided and likely required services during the pandemic, the experiences of CIL staff are often ignored.

To mitigate worsening disparities among PWD during the pandemic, the Administration for Community Living (ACL) offered $150 million to expand the public health workforce in disability and aging networks in the US.25 Through this funding disability and aging agencies, like the CILs, hired and trained public health workers to effectively respond to needs of PWD during the pandemic and prepare for future public health crises. While this funding allowed for research on new/worsening health disparities among PWD, a gap on the impact of the pandemic on disability service providers remains. Also, in the early stages of the pandemic, many survey-based needs assessments to better understand COVID-19 response among PWD showed that the pandemic worsened existing disparities for PWD, due to a lack of access to care.14,18,26 However, an in-depth perspective that systematically and retrospectively looks at the impact of and response to the pandemic among CIL consumers and staff is currently lacking. Thus, this qualitative study provides an in-depth perspective of these disability service providers and their consumers. Findings can be used to address the needs of PWD in Florida and beyond.