When Superstorm Sandy flooded Liz Treston’s home on the South Shore of Long Island, she worried her wheelchair would prevent first responders from rescuing her. So Treston, a quadriplegic, wrote her Social Security number on her arm with a Sharpie, so they could at least identify her body.

She survived, but once the floodwaters receded, officials pushed residents of her Long Beach neighborhood to rebuild their houses on stilts. Treston went along, fearing that if she didn’t, her flood insurance premiums would jump. And, she was told, if her house stayed at ground level, the next storm would turn it into a bowling ball, knocking over the homes around it.

So Treston raised her house 13 feet (4 meters) off the ground, and had enough money to install an elevator. But now she finds the homes around her are mostly off-limits. “I can’t visit anyone in my neighborhood, because they’re all up in the air,” she said.

As climate change makes flooding and hurricanes more severe, federal regulations are forcing cities and towns to raise homes, businesses and public buildings above the expected height of future storms—in some places by as much as 15 or 20 feet. But that vision of resilience is forcing painful questions about whether and how the disabled can remain part of those communities.

“We have to ask ourselves whether we want communities that exclude people with disabilities simply by design,” Marsha Mazz, director of accessibility codes and standards for the United Spinal Association, said in an interview. “In some of these flood-prone areas, I see that as a potential.”

The tension between flood protection and the needs of the disabled goes beyond homes.

Elevated Bathrooms, FEMA Pushback

This year, Florida officials sought to change the national model building code to allow park restrooms in flood zones to be built at ground level. The state’s floodplain manager, Steve Martin, said the continuing increase in projected flood heights requires beach bathrooms to be as much as 20 feet above ground. That means a 300-foot ramp—effectively putting the facilities out of reach for many people.

Increased federal elevation requirements, combined with the need to keep restrooms accessible, “has created an untenable condition,” Martin said in public testimony before the International Code Council, which sets the model codes.

“Constructing restrooms that are 20 feet above grade is not practically accessible”

Another sponsor was Jim Schock, president of the Building Officials Association of Florida. Schock’s wife has a disability that sometimes requires him to push her in a wheelchair.

“Constructing restrooms that are 20 feet above grade is not practically accessible,” Schock said during testimony. “Elevators are also not practical in the salt-air environment. And a ramp system is exhausting.”

The Federal Emergency Management Agency responded by publicly threatening any state that adopted that change with expulsion from the federal flood insurance program. The agency urged the ICC’s members, which include state and local building officials from around the country, to vote down the change. The threat didn’t work: On Wednesday, the council announced that its members had voted to approve Florida’s proposal.

More than 20 million adult Americans reported “serious difficulty walking or climbing stairs” in 2015, according to the U.S. Census Bureau’s American Community Survey. Experts say the true figure is higher if one includes people with temporary impairments, such as an injury, and will rise as the population ages.

Since the 1970s, the federal government has imposed a trade-off on cities and towns by the water. In return for access to federal flood insurance, the ground floor of new or renovated homes or other buildings must be constructed at least as high as the expected level of a so-called 100-year flood. Some communities go farther, insisting that the first floor be built even higher than the federal requirement.

More Flooding Leads to Greater Damage, Aggressive Elevation Requirements

Now, as rising seas, warmer weather and more intense rainfall push flood levels higher, two things are happening: Jurisdictions are setting more aggressive elevation requirements, and more homes are being damaged or destroyed, which means the buildings that replace them are constructed to the updated standards.

The result is waves of transformation in places such as the Northeast after Sandy, as entire neighborhoods of older, low-rise bungalows are wiped out, then reconstituted up in the air. Resilience experts generally praise those changes, calling them necessary to protect residents against the next storm.

And if that means the disabled or elderly have to live somewhere else, some say, then perhaps that’s the price of safety.

“I am committed to being a part of this community. I would hate to be pushed out.”

“Should they be in those high-hazard areas, where they are going to be the least likely populations to withstand the shock of that event?” said Chad Berginnis, executive director of the Association of State Floodplain Managers. “We are blessed in the U.S., where we have a lot of land area that is not flood-prone that people can move to.”

Berginnis knows that this perspective isn’t always popular. As a state official in Ohio almost 20 years ago, he visited a small town to assess its compliance with federal flood standards. The town had granted an exception to a veteran in a wheelchair, allowing him to keep living in a house at ground level, despite being in an area at risk of flash flooding.

“The local perception was, how dare I come in from the state and cause problems for this disabled vet,” Berginnis said. “The other side of this coin is, do you want a disabled vet at risk in a high-hazard area that’s also flood-prone?”

Perhaps unsurprisingly, not everyone agrees. If engineered responses to climate change force the disabled from their homes, the result will be weaker and poorer communities, said Marcie Roth, who until last year was senior adviser for disability issues at FEMA.

“It’s fine to say, well, some people just can’t live here. Does that also mean they can’t work here?” said Roth, who now runs the Partnership for Inclusive Disaster Strategies. “When your community can accommodate a broad cross-section of people, that’s far better for business, far better for the economic engine of that community.”

FEMA Versus the Disabled

FEMA has made it even harder for the disabled, Roth charges, by announcing this year that it would send fewer specialized “disability integration advisers” to disaster areas after hurricanes and other catastrophes. Linda Mastandrea, director of FEMA’s disability integration and coordination office, defended the change, saying in an interview that FEMA’s providing “just-in-time training” to its regular staff to play that role.

“We have seen absolutely no negative impact,” Mastandrea said of the policy shift.

Among those who worry about getting pushed out are Jamie and Steven Prioli, whose home near New Jersey’s shore was flooded by Sandy. Steven Prioli has severe rheumatoid arthritis, which prevents him from climbing stairs; the couple worried that if the government forced them to rebuild higher up, they’d have to leave.

Brick Township eventually sent the Priolis a letter, telling them their house was less than 50 percent damaged—the threshold under federal law for triggering the requirement to elevate. An elated Jamie Prioli called the decision their “golden ticket.”

The Priolis will remain in their house, despite knowing from experience the risk of it being inundated. But Prioli said a lift would cost as much as $15,000, which they don’t have. And it could quickly wear out in the salty air.

Moving isn’t easy, either. Jamie Prioli grew up in the area; her parents live nearby. She works at nearby Ocean County College as an adaptive technology specialist, helping students with disabilities navigate their environment to get an education. And she wants to stay put.

“I am committed to being a part of this community,” Prioli said. “I would hate to be pushed out.”

Her predicament isn’t unique. Many people with a disability don’t have the money to pay for an elevator, said Kenneth Shiotani, a housing attorney with the National Disability Rights Network in Washington. On average, disabled Americans tend to have lower incomes, he said.

Moreover, while the Americans with Disabilities Act requires government and multifamily buildings to be accessible to people in wheelchairs, Shiotani said, single-family homes are exempt.

The result is that the disabled often have few options. And while the government offers programs to help people pay to elevate their homes after a storm, finding programs that will cover the cost of making a house accessible is harder, Roth said.

“It usually requires a tremendous amount of navigation of complex systems,” Roth said. “It’s very trendy and fashionable to talk about resilience. There is very little discussion about disability in those resilience discussions.”

Meanwhile, the passage of time will only make life harder for people in the country’s rapidly elevating waterside communities, Treston warned. The indignities of aging will catch up with everyone.

“They have a bad knee. They have a bad hip,” Treston said of her neighbors in Long Beach, getting used to their new homes up in the air. “It’s not a tragedy to the world. But if you have a physical mobility issue, it’s going to be tough on you to be walking up and down stairs constantly.”