These answers draw in part from “Navigating Wildfires and Disasters For ABA Providers: Here we are. What happens now” by Kelly Bermingham, BCBA (BehaviorLive), and extend it with peer-reviewed research from our library of 27,900+ ABA research articles. Clinical framing, BACB ethics code references, and cross-links below are synthesized by Behaviorist Book Club.
View the original presentation →The first 72 hours should focus on: confirming staff and client safety, identifying which clients and families are directly displaced, activating any telehealth continuity plans, and communicating with all affected families about the service status and timeline. On the organizational side, ensure that financial obligations (payroll, key vendor contracts) can be met from emergency reserves, and begin the process of notifying payers about service disruption. Client safety assessment and behavioral stabilization guidance to caregivers should be initiated as quickly as reachable contact can be established.
Disaster creates widespread routine disruption, sensory unpredictability, and caregiver stress — all potent setting events for problem behavior in autism. BCBAs should focus on behavioral first aid: restoring whatever routine elements are possible, providing simplified emergency visual schedules, ensuring access to high-preference items, and supporting caregivers with specific, practical guidance for managing behavioral challenges in the disrupted context. Simplified, high-priority behavioral protocols replace full programs during the acute disruption period.
HIPAA's Emergency Situations Provisions allow covered entities to modify certain privacy practices when the Department of Health and Human Services declares a public health emergency. Specific provisions include allowing disclosure of PHI to treatment providers, family members, and certain government entities under conditions that would not apply in non-emergency contexts. These provisions are time-limited and condition-specific — BCBAs should not assume that a disaster declaration creates a general suspension of privacy requirements and should consult HIPAA emergency guidance specific to their jurisdiction.
Telehealth can serve as a continuity mechanism for ABA services during displacement, provided that families have internet access, an appropriate device, and the cognitive and emotional capacity to participate. Most payers that authorized ABA telehealth during COVID-19 have maintained some version of remote service authorization; disaster declarations may expand these provisions. BCBAs should know in advance what telehealth authorizations exist under their current payer contracts, what documentation is required, and what service codes apply to remote delivery in their payer agreements.
A comprehensive preparedness plan covers: secure, accessible cloud backup for all client records and clinical documentation; up-to-date emergency contact information for all clients and staff accessible from any location; a documented communication cascade for notifying clients and staff during a crisis; a financial reserve policy sufficient to cover 30-60 days of operations without revenue; telehealth infrastructure activated in advance; and pre-established relationships with payers for emergency authorization and billing flexibility. Plans should be reviewed and tested annually.
Code 2.09 (Discontinuation of Services) requires that service interruptions be managed in ways that minimize harm. BCBAs should: communicate proactively with all affected families about service status and estimated resumption, provide interim behavioral guidance to caregivers for the disruption period, make referrals to emergency services where available, and document the interruption and the clinical rationale for all decisions made during the disruption period. BCBAs should not continue billing for services at authorized levels if they cannot be delivered and should notify payers of service interruption promptly.
Staff who are themselves displaced, experiencing personal loss, or managing acute trauma responses cannot be expected to maintain standard professional performance without support. BCBAs in leadership roles should: check in individually with all affected staff to assess their status and needs, activate employee assistance programs or external mental health resources, make temporary schedule accommodations that acknowledge personal circumstances, and explicitly communicate that staff welfare is a priority alongside client welfare. Organizations that fail to support staff in disaster contexts experience accelerated turnover at exactly the moment they can least afford it.
Behavioral first aid applies the principles of psychological first aid to the specific needs of individuals with autism and developmental disabilities in crisis contexts. It involves assessing immediate safety, providing sensory comfort and routine anchors where possible, supporting caregivers with specific behavioral guidance for managing disruption-driven behavior, simplifying behavioral programs to their most essential components, and maintaining whatever predictability is achievable within the disrupted environment. It does not require full clinical materials or standard session conditions.
Providers who experienced the Maui fires identified several critical lessons: data backup systems accessible outside the local area were essential for clinical continuity; relationships with payers established before the disaster facilitated faster authorization flexibility; staff who had their own basic needs met were more able to continue providing services; community mutual aid networks were more effective than waiting for formal government disaster programs; and re-establishing predictable routines for clients as quickly as possible — even simplified ones in temporary settings — significantly reduced behavioral deterioration during the displacement period.
Field-level improvements include: incorporating emergency preparedness competencies into BCBA graduate training programs; developing standardized behavioral first aid protocols for autism that can be taught to families in advance; creating cross-provider regional networks that can redistribute client cases when individual providers are incapacitated; advocating with payers for pre-established disaster authorization flexibility provisions; and building a shared knowledge base of disaster response experience — as this course does — so that lessons from each event improve preparation for the next.
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Navigating Wildfires and Disasters For ABA Providers: Here we are. What happens now — Kelly Bermingham · 0 BACB General CEUs · $0
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All behavior-analytic intervention is individualized. The information on this page is for educational purposes and does not constitute clinical advice. Treatment decisions should be informed by the best available published research, individualized assessment, and obtained with the informed consent of the client or their legal guardian. Behavior analysts are responsible for practicing within the boundaries of their competence and adhering to the BACB Ethics Code for Behavior Analysts.