California’s plan to make insurer Blue Shield as the main pipeline for coronavirus vaccine is running in an unexpected 11th hour uprising, with Santa Clara County as one of the fiercest critics of the latest distribution scheme.
The daring move has exposed more gaps in the explosion of vaccines in the state and raised questions as to whether the province’s resistance could cut off supplies from the precious shots.
Late Monday, Santa Clara County CEO Jeff Smith announced that his country would not sign a contract to hand over control of the distribution of vaccines to Blue Shield. County Counsel James Williams said Tuesday Santa Clara is still hoping to work out an agreement with the state and is part of a group of counties negotiating to continue receiving vaccines directly and operating their own appointment systems.
Williams said he could not share details about the negotiations or which provinces in the group, except that the state acknowledged their “serious concerns” and that a firm outcome is expected later this week.
Weeks after the sluggish start to California with its COVID-19 vaccination program, the state embarked on Blue Shield to oversee the spread, with top officials promising the health insurance giant would streamline a decentralized, locally-controlled process. But provinces were alarmed, arguing that a lack of supply was the biggest problem and that the local systems that had taken the time and effort to develop were better equipped to disperse the shots quickly and fairly.
Smith said at a meeting of the Board of Supervisors on Tuesday that he was concerned that the addition of Blue Shield posed a significant risk to the health and well-being of residents. That would mean forcing the province to use a new appointment system without any local control, he said. And, Smith added, he’s concerned about a private company that collects protected health information.
San Joaquin County is also participating in the negotiations. “I found our system much more laser-oriented,” San Joaquin County Superintendent Tom Patti said at a board meeting Tuesday.
Contra Costa County officials on Tuesday expressed concern about how Blue Shield would ensure that the most vulnerable residents become vaccinated.
“They did not give us any significant details about how the equity targets will be implemented,” supervisor John Gioia said in a telephone interview.
Gioia also acknowledges the criticism that Smith and some other officials have leveled: that it is inappropriate for Blue Shield to oversee a program from which it derives a financial benefit: ‘I also think it’s a conflict of interest because they are a insurer and they have an interest in accounts for the vaccinations, ‘Gioia said.
Government officials and Blue Shield did not respond to a request for comment Tuesday. Blue Shield said in a statement on Monday that it was finalizing agreements with provinces that would ensure the most dangerous residents are vaccinated.
The uproar comes when Gavin Newsom’s government faces a possible recall campaign, and as residents, desperate for access to the vaccine, become increasingly frustrated with the pace of deployment. Longtime political strategist Dan Schnur said provincial allocation could help Newsom gain more control as local officials are quicker and better at getting shots in the arms.
“It really is not worth fighting for,” Schnur said. “It’s only a political problem when it becomes difficult for people to take their vaccines.”
But William Padula, a professor of pharmaceuticals and health economics at the University of Southern California, believes Blue Shield, with long-standing commitments across the state, has the ability to speed up the distribution process of vaccines and is concerned about the back-and-forth Dialogue between the counties and state is only going to slow things down and hurt Californians.
“To send the state back to the drawing board at this stage to reconsider this public-private partnership is now just putting us further back,” he said.
Although counties are reluctant to sign up with Blue Shield, dozens of other vaccine providers, including hospitals and pharmacies, have done so, including Stanford Health Care and El Camino Health in Santa Clara County, Axis Community Health and La Clinica de la Raza in Alameda County and Albertsons pharmacies at several locations.
Padula thinks this is a good thing.
“I think what we have seen over the last year is that, depending on the government just to deal with the crisis, we have not brought ourselves to the finish line.”
A fixed point in the negotiations is whether provinces should be forced to use the state’s My Turn appointment system, which is caught in mistakes and which doubles the data entry requirements for vaccine providers – which must record information in their own systems as well as the state system.
Ultimately, the deviant provinces may have little choice but to sign up with Blue Shield if they want access to the vaccine. Williams of Santa Clara County said he had received “mixed messages” about whether the state would cut off vaccine supply if provinces did not line up. San Joaquin County Provincial Counsel Mark Myles said he had been assured that the ongoing negotiations would not place restrictions or “chokes” on the amount of vaccine to his country.
Much of the Central Valley was expected to switch to the Blue Shield plan earlier this month, with the Bay Area provinces following by mid-March. But only one country – Kern – signed a contract with the company late Monday, making it unclear how much control Blue Shield currently has.
A spokesman for the public health department in San Joaquin said he was still receiving vaccination from the state.
Los Angeles County – the largest in the state, home to a quarter of California’s population and one of the hardest hit by the deadly virus – said in a statement Tuesday that it continues to “deal with the state and Blue Shield are working together to design a partnership that strengthens the existing extensive and diverse network of vaccination providers and continues to focus on ensuring a fair distribution of vaccine in our hard-hit communities. ”
Joseph Geha and Dan Borenstein reported.