CLEVELAND, Ohio — Maria Pinto, 87, has Alzheimer’s disease and can’t stand or walk. Her Richmond Heights home does not have a wheelchair ramp. She seldom leaves the house. Her family has no idea how they can get her to a COVID-19 vaccination site.
Her son-in-law, Carlos Cherubin, asked Pinto’s primary care physician how he could get the vaccine for her. “We didn’t get a straight answer,” Cherubin said. “They don’t have a process for housebound people. There have gotta be thousands of people like her.”
The state’s vaccination rollout assumes that people who are eligible for the vaccine will be able to get to hospitals or pharmacies giving the shots. That has left Ohioans who can’t leave their homes, and don’t live in nursing homes or senior housing, like Pinto, searching for guidance.
The Western Reserve Area Agency on Aging is assisting all older adults and adults with disabilities to find rides to COVID-19 vaccination sites, said Mary Lipovan, director of public health advocacy for the Western Reserve Area Agency on Aging. But word of this assistance has been slow to reach those who need it.
People who are housebound may need help getting into and out of a car, be an amputee, or have a heart or lung condition that makes walking and climbing stairs difficult, Lipovan said. They may need a wheelchair, scooter or walker to move around.
Individuals with transportation challenges were not excluded from the state’s vaccination rollout plan, Gov. Mike DeWine said in his COVID-19 update on Feb. 4. The state is working with local health departments to formulate plans to reach the housebound. Details will be released soon, DeWine said.
The state is also looking for home health providers who can manage storing and delivering the COVID-19 vaccines to individuals with transportation challenges, Ohio Department of Aging director Ursel McElroy said during DeWine’s briefing.
“We have not forgotten” this population, McElroy said. “We are working on this right now.”
As of Monday, Ohioans 65 and older are eligible for the vaccine. They must find an appointment by consulting a list of about 90 providers across the state, and go online to make appointments. Many have complained that the process is cumbersome and time-consuming for the elderly and their helpers to manage.
About 20.4 million American adults have ambulatory difficulty, according to a 2020 U.S. Census report.
Here is what state and local agencies are doing to help people who can’t leave their homes to connect with vaccine providers:
Ohio Department of Medicaid
People who receive Medicaid, and can get in and out of a car or van, can arrange for non-emergency rides by calling their managed care plan, said Marisa Weisel, deputy director of strategic initiative for the Ohio Department of Medicaid.
Medicaid recipients who need an ambulance or wheelchair van can also make arrangements through their managed care organization, Weisel said.
“We are here to support access to vaccines,” Weisel said.
Managed care organizations are companies that are contracted by the state to provide access to medical care for state Medicaid recipients. These organizations include Aetna, Buckeye Health Plan, CareSource, Molina Healthcare, Paramount Advantage Medicaid and United Healthcare Community Plan.
Transportation help is also available for individuals enrolled in Medicaid’s Fee-for-Service (FFS) program who don’t have a managed care plan. People in the FFS program who need ambulance or wheelchair van transportation can use Medicaid’s online provider directory.
Medicaid recipients can schedule one-way or round-trip transportation. Rides can be prearranged so that individuals don’t have to call for a return ride after the vaccination, she said. The need for roundtrip transportation should be discussed when ride arrangements are made.
Transportation generally needs to be scheduled two business days in advance. Some vaccination appointments are made only 24 hours in advance, instead of the longer notice that managed care providers usually ask for. “Managed care providers will do their best to accommodate that,” Weisel said.
Weisel acknowledged that Medicaid recipients might not realize that their managed care provider can help with COVID-19 vaccination logistics. “There is always more we can do to get the message out,” she said.
Here is a one-page summary of transportation options for COVID-19 testing and vaccination offered by the Ohio Department of Medicaid.
Western Reserve Area Agency on Aging
The Ohio Department of Health and the Ohio Department of Aging are directing people who are homebound or have transportation challenges to call their Area Agency on Aging. In Cuyahoga and its surrounding counties, that is the Western Reserve Area Agency on Aging.
Western Reserve is assisting all older adults and adults with disabilities to find transportation to COVID-19 vaccine clinics. If the person belongs to a managed care plan, Western Reserve will use the plan to arrange transportation. Those who are housebound but do not have a managed care plan that is partnered with Western Reserve, the agency will find local transportation resources for the consumer, Lipovan said.
The agency, which serves five counties, advocates for older adults and adults with disabilities.
Vaccination drive-thru sites are a possibility for people with mobility issues who can get a ride to one, Lipovan said. At a drive-thru site, the disabled person can stay in his or her car to receive the injection.
Tessie Pollock, chief communications officer for the Ohio Department of Aging, said in an email that she had heard of Area Agencies on Aging that “worked out logistics with their local health department to travel to homes if there are available vaccines at the conclusion of public clinics.”
Western Reserve Area Agency on Aging is working on plans to take vaccines to private homes. “The delicate nature of the current vaccine protocols and very limited supply make this difficult to achieve,” Lipovan said.
The Pfizer vaccine must be stored at an extremely cold temperature — minus 70 degrees Celsius — and vials are sent to hospitals and pharmacies in insulated containers that use dry ice to maintain low temperatures. The vials can stay in the containers for only 15 days, and can be thawed in a pharmacy refrigerator for up to five days. Once the vaccine is diluted with saline for injection, it must be used within six hours.
Moderna’s COVID-19 vaccine must be kept frozen as well, but at regular freezer temperatures. Containers of multiple vials can be stored up to 30 days in a pharmacy refrigerator prior to first use. Once the container is opened, all the vials must be used within six hours.
“Western Reserve has received point of dispensing training, including logistician training from the City of Cleveland Health Department, and is working with community partners and (other area agencies on aging) to work out some of the logistical challenges with bringing vaccines to homebound persons,” Lipovan said in a followup email.
That is a service that could help Dr. Helen Kollus, 65, of Lakewood. She has been unable to walk and confined to her home since fracturing her back in 2019. She would like to take the COVID-19 vaccine, but has no way to get to a vaccination site.
Her motorized wheelchair weights about 350 pounds, making it much too heavy for a family member or friend to manage. Her visiting nurse, primary care physician and pharmacy all said they could not help her get the vaccine.
Her private health insurance plan does not cover ambulance rides. Paying out of pocket for an ambulance ride to a vaccination site would cost about $1,000 each way, Kollus said.
“I couldn’t think of what else to do,” she said.
For Kollus and others like her, Ohio’s health officials can’t bring help soon enough.
Here is a list of resources and phone numbers for arranging transportation:
1-855-364-0974, 8 a.m. to 5 p.m.
Buckeye Health Plan
Member Services, Nurse Advice Line, and Transportation
1-866-531-0615, 7 a.m. to 7 p.m. weekdays
1-800-488-0134, 7 a.m. to 7 p.m. weekdays
1-866-642-9279, 7 a.m. to 7 p.m. weekdays
Ohio Dept. of Aging
8 a.m. to 5 p.m. Monday through Friday
For TTY, use Relay Ohio: Dial 711 and use 614-466-5500 for general information.
Ohio Dept. of Medicaid
Consumer Hotline 1-800-324-8680
Paramount Advantage Medicaid
1-866-837-9817, 7 a.m. to 7 p.m. weekdays
United Healthcare Community Plan
1-800-269-4190 7 a.m. to 7 p.m. weekdays
Western Reserve Area Agency on Aging