After a spate of recent natural disasters, some advocates are expressing alarm that federal emergency response efforts are failing to protect the well-being and civil rights of people with disabilities, including by sending them unnecessarily to nursing homes.

The national disability rights group ADAPT recently sent a letter to the Federal Emergency Management Agency, criticizing the release earlier this year of a strategic plan without “preparedness, planning or response elements” specifically for people with disabilities, unlike past plans that addressed disability rights and accessibility. Meanwhile, the Partnership for Inclusive Disaster Strategies, a national coalition, has filed a civil rights complaint naming FEMA and three other federal agencies for failure to provide equal access to shelters.

During recent East Coast hurricanes, advocates say that shelters have lacked reasonable accommodations, including wheelchair accessible restrooms. In some cases, evacuees were sent to nursing homes if they couldn’t return to their previous community residences because of damage when shelters shut down.

“These entities need to adhere to the existing laws,” said German Parodi, an ADAPT organizer in Philadelphia. “You don’t hear of 25-year-old able-bodied people being forced into a nursing home because they want to close a shelter.”

Marcie Roth, CEO of the Partnership for Inclusive Disaster Strategies and FEMA’s former director of disability integration, said people with disabilities are disproportionately affected during natural disasters. She said barriers to help range from a lack of accessible transportation to the complexity of disaster assistance applications.

“People with disabilities are by law a protected class that the federal government is required to provide equal access to,” Roth said. “There are no disaster loopholes. You can’t say, ‘There’s a disaster so therefore we’re going to get to this later.'”

Advocates have expressed concern that not enough federal disability integration advisors have been sent to assist with Hurricane Michael in Florida and Hurricane Florence that struck the Carolinas. As a result, they said some people with disabilities have not been able to get in-person help or information and have been instead directed to the FEMA website or toll-free number.

“I think there’s been a lack of understanding about how people that are in dire situations can be provided with a needed accommodation so they can benefit from services,” said June Isaacson Kailes, a California disability rights consultant who serves on FEMA’s National Advisory Council.

A FEMA spokesperson said the strategic plan will be discussed this week with disability stakeholders. As for sending disability integration advisors, the agency said there is no set number of advisors who respond on the ground to disasters.

“The number of advisors assigned will ebb and flow based on the unique characteristics of the disaster, impacted communities and identified needs of disaster survivors with disabilities,” the spokesperson said in a statement.

Kailes said she plans to discuss disability response concerns at an upcoming advisory meeting, noting that the challenges of a disability intensify during a disaster.

“When you live with a disability, you always live in a heightened state of preparation. You’re always problem-solving and thinking about things no one else has to think about,” she said. “Planning for this in terms of protecting our independence, safety and health is a critical piece.”