As the focus on COVID-19 fades and the federal government eyes an end to the emergency status that the pandemic triggered, officials are warning that big changes are coming for some disability programs.

Currently, the nation is under a public health emergency. With that in place, states have been able to access extra federal money for Medicaid so long as they do not drop most beneficiaries from the program. Federal officials also granted extra flexibility to home and community-based services providers who have been struggling to maintain staffing during the pandemic.

U.S. Secretary of Health and Human Services Xavier Becerra recently extended the public health emergency until July 15, but it’s unknown if the Biden administration will renew the designation beyond that point. Now, the Department of Health and Human Services’ Administration for Community Living is telling people with disabilities to be prepared.

“When the federal declaration of a public health emergency (PHE) expires, many of the flexibilities initiated during the PHE will need to be rolled back. This return to pre-pandemic operations will have far-reaching impacts for older adults and people with disabilities,” reads a notice from the agency. “Changes in Medicaid enrollment and eligibility will be particularly important — and potentially confusing or disruptive — for current enrollees.”

M.K. had never really had a close friend. And, in his late 20s, he’d certainly never had an intimate relationship with a woman.

But Ishah Fehon entered his life in a big way in 2019. She got him out of his Beaverton apartment and opened a new world to him. They barbecued, went to the beach, and played Frisbee golf. And, allegedly, they had sex.

Except Fehon was not M.K.’s girlfriend. She was his paid caregiver. He suffers from autism spectrum disorder and a number of associated impairments. And Oregon law says intimate contact between a caregiver and a client is sexual abuse.

A new lawsuit filed May 3 in Multnomah County Circuit Court exposes a thorny issue that gets little attention from law enforcement or the courts—the sexual abuse of disabled Oregonians like M.K. (WW does not identify alleged victims of sexual abuse without their consent.)

“This is a vulnerable population who has inherent difficulty advocating for itself, and people who are highly dependent on caregivers, often in their home,” says M.K.’s attorney, Peter Janci of the Portland law firm Crew Janci. “And there’s very little supervision.”

The lawsuit Janci filed this week alleges that two companies responsible for M.K.’s care—Self-Determination Resources Inc., a Beaverton nonprofit, and Destination: Autonomy LLC, a for-profit company headquartered in Hillsboro—were negligent in the provision of his care, resulting in “physical abuse of a vulnerable person.” The lawsuit seeks $6.25 million in damages.

The Ohio Department of Developmental Disabilities launched a pilot with StationMD to provide 24/7 urgent telemedicine for up to 5,000 individuals with intellectual and developmental disabilities (I/DD).

StationMD uses telemedicine to deliver urgent care and behavioral health services to people with I/DD, which includes those with autism spectrum disorder, cerebral palsy, down syndrome and other intellectual and developmental impairments.

People with I/DD often have complex medical and behavioral issues that require a doctor’s immediate attention. Before this pilot, those individuals had nowhere else to go except for the ER, according to StationMD.

“Through StationMD’s partnership with the Ohio DODD, we are elevating the quality of care people with I/DD receive in Ohio. Whether an individual lives in urban Cincinnati or in a more rural area of the state, they now have immediate access to a team of doctors who understand their medical needs, and they can reach us on-demand, 24/7,” said Dr. Maulik Trivedi, Cofounding Physician at StationMD.