Table 21. Recommendations to ameliorate the findings of a negative impact of COVID-19 for persons with IDD, family members, and those working in the disability field.

Persons with IDD	Family members	Direct support staff and management in disability organisations
Develop timely, accessible, accurate and informative materials on COVID-19 for persons with IDD.	Provide resources for family members on how best to respond if they observe changes in the person they support, for example, in mood and/or behaviours indicative of diminished wellbeing.	Conduct a wide-ranging consultation among disabled persons’ organisations, disability providers, government and other stakeholders regarding the options to avoid the closure of disability services during periods of risk.
Ensure continuity of support services is prioritised during periods of risk. Disability support services must be classified as essential services that cannot be withdrawn.	Address family members’ concerns to contact healthcare providers during periods of risk to address their own or their family members’ health needs.	Confer disability support professionals with essential worker status on a par with other health workers and identify and prepare suitable alternatives if a reduction of existing disability support services is unavoidable during periods of risk.
Ensure engagement with family and friends are always facilitated during periods of risk, if necessary, via online methods.	Develop and implement protocols for family members specifying how to report incidents of exploitation against persons with IDD.	Secure funding from central government for online and other remote options required to ensure continuity of service during periods of risk.
Proactively lobby governments to implement long-term policies to close congregated settings, or introduce such policies if they do not exist, notably given the elevated risk of exposure during pandemics. Where these exist, ensure those living in such settings are prioritised during periods of risk.	Provide guidance to family members to recognise the presentation of COVID- 19 symptoms among persons with IDD taking a ‘higher index of suspicion’ approach.	Develop and implement protocols to guide the re-introduction of disability support services with minimal disruption to persons with IDD.
Develop and implement protocols with healthcare providers to plan for uninterrupted access to healthcare for persons with IDD.	Engage with family members to develop protocols for COVID-19 testing and treatment options for their family member with IDD.	Develop and implement protocols to address any shortage of staff during periods of risk, with reliance on casual staff to breach the gap as an emergency response only.
Triage protocols within acute hospital sector should be reviewed by disability persons’ organisations to avoid discriminatory practices.	Develop and implement protocols for family members accompanying their family member with IDD to hospital to ensure they are identified with the status of support person as opposed to visitor.	Renumerate staff for additional workload during periods of risk.
Engage with individuals with IDD to develop and implement protocols for COVID-19 testing and treatment options.	Disability support services should support family members to ensure a clear plan is available regarding the support of their family member with IDD in the event the caregiver becomes ill.	Develop timely, accessible, accurate and informative materials on COVID-19 for staff working in disability support services.
Ensure that extra costs incurred during periods of risk are covered by central government and local authorities are not taken from disability allowances and/or personal budgets of individuals or family members of persons with IDD.	Develop timely, accessible, accurate and informative materials on COVID-19 for family members.	Address the reluctance by some direct support staff to report incidents of exploitation against persons with IDD.
Develop and implement protocols for the inclusion of disability variables, as per the guidance of the UN Washington Group, in routine national and international health interview and health examination surveys.	Liaise with unions and employers regarding the duties of employees who are caregivers and may require paid time- off from work.	Develop and implement protocols to ensure timely access to PPE, isolation and testing facilities.
	Liaise with unions and employers regarding the possibility of flexible working hours to accommodate employees who are caregivers.	Facilitate access to psychological supports for staff working in disability support services.
	Facilitate access to psychological supports for family caregivers.	Support research to explore factors contributing to high levels of stress, depression and anxiety among disability staff which can inform interventions to ameliorate distress.
	Support research to explore factors contributing to high levels of stress, depression and anxiety among family members which can inform interventions to ameliorate this distress.