Advocates are demanding Philadelphia change key parts of its vaccine rollout to be more inclusive of people with disabilities.

More than a dozen advocacy groups along with Councilmembers Derek Green, Mark Squilla, and Helen Gym sent a letter Monday to Mayor Jim Kenney and Health Commissioner Thomas Farley, calling for changes around COVID-19 vaccine eligibility, clinic accessibility, and communication. They expressed concern that the health department is leaving behind some of the city’s most vulnerable residents in its effort to get shots into people’s arms.

“We have heard from many Philadelphians with disabilities who believe the city has failed to engage them in conversations about vaccine prioritization and how to best meet their needs,” the letter reads.

The city said it was reviewing the letter’s recommendations.

“We appreciate this organization’s detailed and thorough review of the situation and will prepare a response that takes into account the recommendations that we have already accomplished, and the status of others,” health department spokesperson James Garrow said in an email.

Advocates have been raising many of these concerns around vaccine prioritization and planning since the winter, said Anna Perng, the cofounder of the Chinatown Disability Advocacy Project. She said she remains frustrated by what she sees as people with disabilities not having equitable access to the vaccine supply.

Philadelphia officials expect to make all adults eligible to be vaccinated by May 1, but Perng said she is concerned that doing so will push people with disabilities to the back of the line.

“That’s the very definition of ableism, this perception that everything is opening up and the disability community and those at high risk should just stay home. People with disabilities have the right to access the community and their schools as much as anyone else,” said Perng, an Asian American advocate who is disabled.

Philadelphia establishes its own vaccine guidelines, separate from the Pennsylvania Department of Health’s rules for other counties across the commonwealth. The letter points out instances where the city’s plan differs and asks for immediate changes.

Unpaid caregivers of people with disabilities in the city are not eligible to be vaccinated but would be if they lived elsewhere. People receiving home and community-based services, a program allowing them to remain at home rather than in a long-term care facility, are also prioritized in the commonwealth’s vaccine plan, but not the city’s.

Philadelphia expanded vaccine eligibility earlier this month to include people with intellectual disabilities but has not yet updated its vaccine interest form to include this population, an omission that could be a barrier for people who need to let the city know they are part of this group.

The letter calls on the city to update its vaccine sign-up site to include people with intellectual disabilities, and broaden eligibility to the entire population of people with disabilities, their caregivers, and those receiving or qualifying for home and community-based services. The letter also cites an October Temple University report that showed people with intellectual and developmental disabilities are at a higher risk of dying from the coronavirus.

At last week’s City Council meeting, Councilmember Derek Green, a father of a young adult with autism, called on the health department to expand vaccine eligibility rules to include more people with disabilities and their caregivers.

“It makes no sense we are basically discriminating against those who are personal caregivers for their children,” he said.

Advocates also asked for the city to redefine congregate settings. Currently, it is limited to facilities with 20 or more residents. The letter argues that many people with disabilities may live with others and experience high exposure to COVID-19 without meeting the 20-person threshold.

The letter also includes recommendations around vaccine clinics. The Eagles Autism Foundation and Divine Providence Village, a residential facility in Delaware County, hosted a clinic for people with intellectual disabilities, specifically catered to the autism community. This type of accommodation, the letter says, should be more widespread.

The letters asks for the health department to create a variety of clinics to meet the needs of its diverse community, whether those waiting to be vaccinated have sensory issues that would make it hard to wear a mask, are sensitive to loud noises, are physically unable to wait in line for hours, or are deaf.

Advocates also recommended more community clinics so fewer people with disabilities have to use public transportation; drive-through clinics and in-home vaccinations for those who cannot travel or stand in line; partnerships with disability-rights groups for pop-up clinics; and additional accommodations, such as clear panel masks for site staff instead of regular masks, which block the ability for someone who is deaf to read lips.

“Given that no one model of administering vaccinations seems to meet the needs of all vulnerable Philadelphians, we urge the city to utilize a variety of different sites and distribution methods,” the letter reads.

The letter also called for the city to include disability data on its data dashboard, more communication, and the creation of a disability working group for the vaccine rollout.

“Disability stakeholders are ready to assist the city and its community vaccination partners in reaching the most vulnerable Philadelphians,” the letter states.

Read the full letter here: