By Matt Harrington, BCBA · Behaviorist Book Club · April 2026 · 12 min read

Disaster Preparedness and Recovery for ABA Providers: Lessons from Maui and Southern California

Overview & Clinical Significance

Natural disasters present ABA providers with operational and clinical challenges that standard training does not prepare practitioners for. When a wildfire, hurricane, flood, or other mass casualty event affects a service area, the disruption is immediate and multilayered: staff and clients may lose their homes, therapy materials are destroyed, clinical data is inaccessible, authorization periods lapse, and the emotional and behavioral effects on clients with autism — for whom predictability and routine are foundational — can be severe.

Presented by Kelly Bermingham and drawing on direct experience with the Maui fires and the 2025 Southern California fires, this course provides ABA providers with a concrete, timeline-based framework for response, recovery, and rebuilding after a natural disaster. Rather than generic emergency preparedness content, it is grounded in the specific experience of behavioral health providers who have navigated exactly these challenges — what worked, what failed, and what resources were most valuable.

The clinical significance for BCBAs is substantial. Individuals with autism spectrum disorder often have significant difficulty coping with disruption to routine, unexpected environmental changes, and the secondary behavioral effects of caregiver stress and anxiety. Natural disasters create conditions that are antecedent to nearly every problem behavior that ABA programs are designed to address. BCBAs who have a pre-established disaster response framework are in a fundamentally better position to support their clients through these events — and to maintain some continuity of intervention even in severely disrupted conditions.

This course also addresses organizational resilience — the capacity of an ABA business to survive operational disruption without dissolving its clinical programs. Organizations that have disaster protocols, documented clinical data backed up securely, and pre-established relationships with payers and referral sources recover faster and with less harm to clients and staff than those responding ad hoc.

Background & Context

The frequency and severity of natural disasters affecting populated areas in the United States has increased substantially over the past decade. California, Hawaii, the Gulf Coast, and hurricane-belt states have all experienced significant events that disrupted healthcare delivery at a population scale. ABA providers are disproportionately affected relative to some other healthcare sectors because of the nature of their service model: intensive, relationship-dependent, routine-based services for clients who have limited capacity to self-manage disruption.

The 2023 Maui fires caused the near-total destruction of the historic community of Lahaina and displaced thousands of residents, including families of children with autism who were receiving ABA services. ABA providers in Maui documented the challenges of maintaining services during displacement: clients who had lost all routines and behavioral anchors, staff who had lost their own homes, and organizations whose physical infrastructure was destroyed. The lessons from that event directly informed the response framework shared in this course.

The 2025 Southern California fires — affecting communities in the Los Angeles area with some of the highest concentrations of ABA clients in the country — created a parallel situation on a larger scale. The healthcare infrastructure disruption, combined with widespread displacement of families and staff, created the kind of crisis that exposes the preparedness gaps in any organization.

Emergency preparedness in behavioral healthcare is addressed in federal and state emergency management frameworks, including FEMA's healthcare coalition guidance and state behavioral health disaster plans. HIPAA has specific provisions for how protected health information can be used and disclosed during declared emergencies. BCBAs should be aware of these frameworks and ensure that their disaster response plans are consistent with them.

Clinical Implications

The behavioral effects of disaster on individuals with autism are predictable from first principles. Disruption of routine — among the most powerful setting events for problem behavior in this population — is pervasive in disaster contexts. Evacuation means leaving familiar environments. Displacement means unpredictable schedules, unfamiliar caregivers, and absence of preferred materials. Caregiver stress directly affects the quality of behavioral support available at home. Sleep disruption — nearly universal in disaster contexts — affects both behavior and the effectiveness of any intervention.

BCBAs responding to disaster-affected clients should prioritize behavioral first aid: rapid assessment of the client's current behavioral status, identification of which environmental anchors can be restored or approximated, and implementation of simplified behavioral protocols that do not require full access to therapy materials or standard session conditions. Emergency visual schedules, access to preferred items where possible, and maintenance of whatever routine elements can be preserved are among the most impactful immediate interventions.

For organizations providing services to displaced clients, telehealth may serve as a continuity mechanism. Most payers that implemented telehealth flexibilities during COVID-19 have maintained some form of remote service authorization, and disaster declarations frequently trigger additional telehealth access provisions. BCBAs should know in advance what telehealth options are available under their current payer contracts and what technical requirements apply.

Caregiver support is a clinical priority in disaster contexts that goes beyond the standard parent training frame. Caregivers who have lost their homes, are managing their own acute trauma responses, and are simultaneously trying to maintain behavioral supports for a child with autism are under extreme stress. BCBAs providing any level of clinical contact during the acute disaster period should include explicit caregiver stress assessment and support in their clinical approach.

Clinical documentation recovery is a practical concern that has direct continuity of care implications. BCBAs should ensure that client records — behavioral programs, assessment results, authorization documentation — are backed up to cloud storage systems that are accessible from any location. Loss of physical documentation in a disaster should not result in loss of clinical history.

Ethical Considerations

Code 2.01 (Effective Treatment) continues to apply during disasters, though the practical constraints on intervention quality may require documented accommodation. BCBAs who cannot maintain standard service intensity due to disaster-related disruption should document the specific barriers, the alternative interventions being provided, and the plan for restoration of standard services as conditions allow. This documentation protects clients, provides a clinical record for continuity, and demonstrates good-faith effort to maintain service quality.

Code 2.06 (Maintaining Confidentiality) applies even during disaster response. HIPAA emergency provisions allow certain disclosures that would not be permitted under standard conditions — but these provisions are specific and limited. BCBAs should understand what HIPAA emergency provisions apply to their jurisdiction and their specific situation, and should not assume that disaster conditions create a general suspension of confidentiality obligations.

Code 4.07 (Staff Welfare) has particular salience in disaster contexts. Staff who have themselves been displaced or who have experienced personal loss while continuing to provide services are under conditions of significant stress. BCBAs in organizational leadership roles have an obligation to monitor staff welfare, provide support resources, and make reasonable accommodations that acknowledge the extraordinary conditions under which staff are working. Organizations that push staff to maintain normal performance standards in disaster conditions create both ethical and practical harm.

Code 2.09 (Discontinuation of Services) establishes that BCBAs must manage service interruptions in ways that minimize harm to clients. When disaster forces a service interruption, BCBAs should proactively communicate with families about the timeline and plan for service restoration, provide interim guidance for maintaining behavioral supports at home, and make referrals where possible when restoration of services is not possible within a clinically appropriate timeframe.

Code 6.01 (Truthful Descriptions) requires honest communication with payers and referral sources about disaster-related service impacts. BCBAs should not continue billing for services that cannot be delivered at authorized levels due to disaster conditions, and should proactively communicate with payers about service interruption and resumption timelines.

Assessment & Decision-Making

Effective disaster response begins with pre-disaster preparedness assessment — an organizational evaluation of readiness across several domains before a disaster occurs. BCBAs in clinical leadership roles should assess: Are client records backed up to accessible cloud storage? Do staff know what the disaster response protocol is? Are caregiver contacts current and accessible from outside the office? Are there pre-established relationships with regional payers and referral networks that can be activated during a crisis?

In the acute phase of disaster response, BCBAs should conduct a rapid triage assessment of their client population: Which clients are directly affected by displacement or family loss? Which clients have the most fragile behavioral profiles and will be most severely affected by routine disruption? Which clients have caregiver networks strong enough to manage short-term disruption independently? This triage guides where to focus initial clinical contact resources.

Timeline-based decision-making — the structure emphasized in this course — requires distinguishing between acute response (first 72 hours), early recovery (first 30 days), and long-term recovery (30+ days). Different actions are appropriate in each phase. Acute response prioritizes safety and behavioral stabilization. Early recovery focuses on service continuity, documentation restoration, and family support. Long-term recovery rebuilds clinical programs, addresses cumulative stress effects, and evaluates what systemic changes are needed to improve future preparedness.

Decision-making about when to resume standard service intensity should be based on client behavioral status, caregiver capacity, and organizational operational readiness — not on administrative pressures to return to billing normality. BCBAs who resume full service schedules before the clinical and operational conditions support effective delivery are compromising service quality without reducing organizational risk.

For clients whose behavioral status has significantly deteriorated during the disaster period, a re-baseline assessment — treating the post-disaster presentation as a new baseline rather than attempting to resume pre-disaster programs unchanged — produces more clinically valid starting points for recovery-phase programming.

What This Means for Your Practice

The central message of this course for practicing BCBAs is that disaster preparedness is a clinical responsibility, not just an administrative or organizational one. When your clients' safety and behavioral wellbeing are at stake in a disaster, your preparedness — or lack of it — directly determines how well you can support them.

For BCBAs in organizational roles, the most actionable starting point is conducting a preparedness audit: reviewing data backup systems, updating caregiver contact information, documenting disaster response protocols for staff, and verifying payer requirements for telehealth and service interruption notification. These are low-cost, high-value preparedness activities that take hours to complete but could preserve months of clinical continuity.

For BCBAs in direct practice roles, the behavioral first aid framework is the most immediately applicable skill set. If a client's routine is severely disrupted by any crisis — not just a natural disaster — the same principles apply: restore what anchors you can, simplify behavioral protocols to what is feasible in the disrupted context, prioritize caregiver support, and document what you are doing and why.

For the field as a whole, the disasters described in this course represent an opportunity to build organizational knowledge about disaster response into standard BCBA training. Emergency preparedness competencies are not currently required in graduate ABA training programs, and the growing frequency of climate-related disasters suggests this gap will become increasingly costly.