Letters & Testimony

Alabama Arise, partners urge COVID-19 vaccine priority for Alabamians served through Medicaid waivers

Alabamians served through home- and community-based Medicaid waivers qualify for nursing home care but receive their care at home from community providers through the state’s Medicaid waiver program. The Alabama Department of Public Health (ADPH) has acknowledged that these individuals belong in the Phase 1a priority level for the COVID-19 vaccine. But they have not yet received access to the vaccinations.

Alabama Arise and partner groups sent the following letter to Gov. Kay Ivey on Thursday in response:

Letter text

Dear Governor Ivey,

We hope you are well and breathing a little easier as spring approaches with better COVID news each day. In response to our previous letter of a month ago, you invited us to get back with you in a few weeks if we had further concerns about the vaccination roll-out. Recent trends are encouraging, but we do want to highlight an ongoing issue that has not been resolved.

After we sent our Jan. 15 letter, we learned that program directors at Alabama Medicaid, Alabama Department of Senior Services, Alabama Department of Mental Health and Alabama Department of Rehabilitation Services contacted Dr. [Scott] Harris to express their concern about the lack of vaccination planning for the Medicaid long-term care patients they serve through home- and community based service waivers. As individuals who qualify for nursing-home care but receive their care at home from community providers, waiver patients are equivalent to nursing home residents in their vulnerability to COVID-19, as well as their legal status. ADPH has acknowledged that these patients belong in the 1a vaccination priority level, but they have not been granted access to vaccinations.

We understand that the agencies offered to assist ADPH with outreach and other logistical planning to ensure timely vaccination of these vulnerable individuals. “Timely” is the critical word. The longer we wait to vaccinate the top priority populations, the more hospitalizations and deaths Alabama will experience on our way to generalized immunity. As of Wednesday afternoon, the other health agencies were still waiting to hear how they could engage with ADPH in this vital effort. We recognize the enormous task facing the department and applaud its perseverance under trying circumstances. Rather than calling that work into question, we offer this appeal in the belief that an inter-agency strategy will lighten ADPH’s load.

One example of such collaboration comes from Delaware, where paratransit resources are being deployed in a “reverse paratransit” network to deliver vaccines and vaccinators to the homes of paratransit users as vaccine supply becomes available. We have shared this model with ADPH and understand that Dr. Mary McIntyre has contacted the Delaware program to learn more. We hope to see similar ideas embraced here in Alabama. We would appreciate anything you can do to expedite an inter-agency partnership to make vaccinations available to our most vulnerable Alabamians as soon as supplies allow.

Thank you for your consideration.


Respectfully submitted by:

Jim Carnes
Policy Director, Alabama Arise

James A. Tucker, Esq.
Director, Alabama Disabilities Advocacy Program
The Protection and Advocacy System for the State of Alabama

Eric M. Peebles, Ph.D., CRC
Chair, Consumer Advisory Committee, Alabama Select Network
President, Disabilities Leadership Coalition of Alabama
Treasurer, State of Alabama Independent Living Council
President and Chief Executive Officer, Abilities Unlimited LLC dba Accessible Alabama