The regional agency that administers a key Medicaid disability waiver across Mobile, Baldwin and Escambia counties says it is reviewing growing allegations that families of children with disabilities were wrongly denied services, and in some cases had their doctors’ paperwork altered to strip out qualifying conditions.
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The South Alabama Regional Planning Commission, whose Area Agency on Aging serves as the local case-management arm for Medicaid’s Elderly and Disabled Waiver, acknowledged the concerns in an emailed response but offered few specifics. \”We are aware of the concerns that have been raised regarding the administration of the Elderly and Disabled Medicaid Waiver program,\” Executive Director John F. \”Rickey\” Rhodes said. \”These allegations are taken seriously and are currently being reviewed through the appropriate administrative processes.\”
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What families say happened
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Numerous families have come forward on the record describing a pattern: after being denied services under the waiver, they discovered that documents submitted by their physicians had been edited without their permission, removing the qualifying criteria that made their children eligible. The Elderly and Disabled Waiver exists to help people with physical and developmental disabilities receive care at home rather than being institutionalized, making the paperwork the difference between services and none.
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Three families — two in Fairhope and one in Gulf Shores — shared accounts of altered forms. They had different case managers assigned to them, but both municipalities fall under SARPC’s coverage area. The families have begun asking whether front-line case workers were instructed to change documentation practices, or even pushed toward quotas on denials. SARPC did not directly address those questions. \”Our responsibility to protect the privacy of those involved limits the information we can share publicly at this time,\” Rhodes said, adding that the agency remains committed to administering programs in accordance with federal and state requirements and to treating families fairly and respectfully.
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The state’s answer
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The waiver is operated by the Alabama Department of Senior Services under a program approved by the Centers for Medicare & Medicaid Services. State officials flatly denied any wrongdoing. The Alabama Medicaid Agency and ADSS, in a joint response, stated that no applicants have been turned away due to \”enrollment-reduction goals, savings targets, or denial benchmarks.\”
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The agencies pointed families who lose waiver services toward the administrative remedies built into the program: informal conferences, fair hearings, and continuation of benefits during review where applicable. They also noted that anyone may reapply at any time with new or additional documentation showing eligibility.
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Gov. Kay Ivey’s office declined to comment, with deputy communications director Mike Lewis referring questions back to the two state agencies.
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Who oversees the agency
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SARPC’s Board of Directors includes some of the region’s most prominent officials: Baldwin County Commissioner Charles F. \”Skip\” Gruber as chairman, Satsuma Mayor Mark Barlow, Escambia County Commissioner Larry White, U.S. Rep. Shomari Figures, U.S. Rep. Barry Moore, and State Board of Education member Jackie Zeigler. None responded to a request for comment on the allegations.
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Candidates start talking about Medicaid
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The denials have become a campaign issue. Democratic gubernatorial candidate Doug Jones, the former U.S. senator, gave a pointed response, saying he knows families affected and that the problems suggest something broader in Alabama’s Medicaid system.
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\”These reports are deeply disturbing and clearly indicate that there is an undisclosed agenda at play,\” Jones said in a statement. \”I personally know some of the families going through this. No family raising a child with significant disabilities should have to fight in the dark for benefits their kids have already qualified for.\” He said Alabama’s waiver program must follow federal law and provide \”clear, published guidance and actual data on denials, appeals, and reversals,\” and pledged to make the issue a priority if elected governor.
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Democratic lieutenant governor candidate Phillip Ensler called for an independent review as well as one by the legislature. \”There needs to be an independent review as well as a review by the legislature. The state has a responsibility to understand why the forms were altered so that these families get the answers they deserve,\” Ensler said. He argued families deserve clearer explanations of how waiver decisions are made: written reasoning for every denial and a clear statement from the treating physician, and notification when the criteria change.
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Republican candidates have been quieter. Gubernatorial candidate Tommy Tuberville’s campaign did not acknowledge questions, and lieutenant governor candidate John Wahl did not respond. Both attorney general candidates, Republican Katherine Robertson and Democrat Jeff McLaughlin, declined to comment on their positions, including whether the office should continue supporting Alabama’s amicus position in a pending 11th Circuit case, United States v. Florida, that tests whether states can be held liable under the ADA’s integration mandate when disabled people face a serious risk of institutionalization. Attorney General Steve Marshall quietly joined Georgia in that brief in June. Robertson is his chief counsel; McLaughlin is a Guntersville attorney who served in the Alabama House from 2001 to 2010.
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What families can do now
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For the families in the middle of this, the practical options are the ones the state agencies named: request an informal conference, file for a fair hearing, keep benefits during review where applicable, and reapply with additional physician documentation. Advocates add one more: keep copies of everything a doctor signs, so that any later alteration can be demonstrated. Whether the SARPC review produces public findings, or changes in how case managers handle physician forms, remains the open question — and the one lawmakers and candidates say they will be watching.
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