Advocates: State’s new COVID-19 vaccine plan could worsen inequities
In an effort to allow those with high-risk medical conditions to jump the COVID-19 vaccine line, advocates say the state may have pushed people in vulnerable communities to the back of the line.
Kenyatta Thompson, director of organizing for the Katal Center for Equity, Health, and Justice, said the state’s shift from a strictly age-based rollout is a “step in the right direction,” but how high-risk patients will be identified is a question she said needs to be answered.
Gov. Ned Lamont announced this week that everyone age 16 and over would be eligible on April 5, with prioritization for people with medical conditions that put them at a higher risk of COVID complications.
But questions persist if high-risk individuals would need a doctor’s note or medical records to get priority.
“There are communities where access to a primary care physician is difficult, and I think to ignore that would be disingenuous,” Thompson said. “There are people right now who don’t have access to a primary care physician.”
Answers to questions like that will be key, advocates say, if high-risk patients living in vulnerable communities won’t be left behind.
“Even though they are high risk, they might not be prioritized in this plan,” Thompson said.
State officials said Tuesday that vaccine providers would be in charge of the logistics and details. According to Ohm Deshpande, of Yale New Haven Hospital, those details are not yet fleshed out.
“There is no clarity yet,” he said. “The goal is to not have an inequitable process. Any sort of construct that we come up with will have to be equitable.”
The difficult question is determining what puts someone at higher risk of a severe COVID-19 infection.
The Centers for Disease Control and Prevention has a list of medical conditions that increase a patient’s risk of a severe reaction to the coronavirus infection, but there has been no agreement yet among Connecticut’s vaccine providers if that list will be followed, and how a patient might prove they are at greater risk.
People with pulmonary disorders, obesity, or who smoke cigarettes are considered “at risk,” according to the CDC, but Thompson
noted that people of color have borne the brunt of the pandemic from the start, dying at greater rates from the virus than their white neighbors.
“I don’t even think we can take race out of this,” she said. “This is not a race-neutral issue.”
Kathy Flaherty, executive director of the Connecticut Legal Rights Project, said she was not in favor of the state’s initial age-based rollout, but this week’s shift without any “specificity” has raised some ire.
“Going back and forth with no guidance, no specificity about what any of that means,” she said. “I have people asking me what that means, and I’m like, ‘I have no clue, go ask the governor.’”
Flaherty said she expects any system designed to
help people at risk because of a disability, a medical condition or race to be exploited.
“We have laws to protect us that people with privilege will use to their advantage,” said Flaherty, who advocates for people with disabilities. “People of means will always figure out a way to manipulate a system to their advantage.”
As for how it will work, Deshpande said, “The simple answer is, I don’t know yet,” though equity will be “at the top of our list of priorities.”
“Just because you have a PCP should not give you a leg up,” he said.
There have been efforts to prioritize ZIP codes in the state with a resident population considered vulnerable, those that fall high on the CDC’s social
vulnerability index, and those goals “continue to be a strategic imperative,” Deshpande said.
But as providers now are structuring a system in which people more at risk have easier access to vaccines, those efforts will have to be “redoubled,” he said.
Requiring access to a primary care provider is one way a system could exacerbate existing health care inequities, Thompson said. People “should not be hindered by the fact that they don’t have a regular PCP.”
She and Flaherty suggested a sort of honor system, where a patient would schedule their own vaccine appointments and not be required to prove that they have a high-risk condition.
“What you could have
done and what they did in other places is, you literally have people attest,” Flaherty said. “Will some people cheat? Yes, because some people always cheat.”
Jerry Smart, a community health worker in New Haven working with patients recently released from prison, said that lack of trust is also a concern.
“The Black and brown community really don’t trust the health care system,” he said.
There are issues accessing physicians and transportation, but people like Smart and Latoya Benton, a Bridgeport-based community health worker, often bridge that gap between patient and doctor.
“If you already have a doctor, it’s easy to prove what you have because it’s all in the records,” Benton said.
Another problem is finding those people who fall through the cracks, who have lost trust in the health care system or have no fixed address, and making sure they know they can get vaccinated sooner if they have a preexisting condition.
“Right now they’re trying to get the word out,” Benton said. “It’s harder for the community to know where to get the vaccine, and what days to get the vaccine.”
The solution, according to Smart, is not to ask people to go get a vaccine, but to send vaccines where the people are.
“Some people just don’t have cellphones. Some people don’t have addresses,” he said. “You have to get your troops out there, meet the people where they’re at. That’s how you have to do it.”
WASHINGTON — Connecticut will receive $107 million in new federal funding to increase coronavirus testing in public K-12 schools, the U.S. Centers for Disease Control and Prevention announced Wednesday, as the Biden administration floods schools with money in an effort to restart classroom learning across the country.
The new testing money will flow to the state Department of Public Health by early April, but information was not available Wednesday on how it will then be used or distributed to individual school districts.
The testing money comes on top of more than $1.1 billion that the U.S. Department of Education is sending to Connecticut primary and secondary schools to push school reopening. It’s part of billions in federal relief money flowing to the state from the American Rescue Plan, the $1.9 trillion coronavirus relief package that President Joe Biden signed into law last week.
“These funds from the American Rescue Plan and the extraordinary steps the Department is taking to get these resources to states quickly will allow schools to invest in mitigation strategies to get students back in the classroom and stay there, and address the many impacts this pandemic has had on students — especially those disproportionately impacted by the pandemic,” U.S. Secretary of Education and former Connecticut Commissioner of Education Miguel Cardona said.
As of March 8, about 61 percent of Connecticut schools are teaching fully in-person, said Peter Yazbak, director of communications for the state Department of Education.
At least a few Connecticut school districts including Middletown and East Haven have offered some coronavirus testing on site, but it’s unclear how widely available COVID-19 testing is at public schools in the state. The Department of Education referred questions on the subject to the Department of Public Health, which did not answer. The Connecticut Education Association, the state’s teacher’s union, also did not have data to share.
The Connecticut Education Association has called for all schools, with state assistance, to provide regular COVID-19 testing of students and staff to check for both symptomatic and asymptomatic cases.
Teachers and school staff have been able to get priority access to other coronavirus testing sites in Connecticut through an initiative set up by the state.
Biden has set a goal of having a majority of schools reopen for in-person learning five days a week by April 30, Biden’s 100th day in office.
To help schools reopen, fight learning loss and shoulder other new expenses, the American Rescue Plan is pumping an unprecedented amount of money into public schools using Title I, a formula that supports schools educating low-income students. Biden has encouraged states to prioritize vaccinating teachers and school staff, which Connecticut has done.
The CDC has issued new guidance for school reopening and is re-evaluating whether three feet of physical distancing — not six — might be sufficient in schools when all students are masked. The CDC is promoting and funding increased coronavirus testing in schools as one strategy to help more classrooms stay open.
In addition to ensuring diagnostic testing of symptomatic and exposed individuals, serial screening testing will help schools identify infected individuals without symptoms who may be contagious so that prompt action can be taken to prevent further transmission, the CDC said announcing the new funding awards Wednesday.
“We know that testing works. We know that it works to identify cases and slow the spread of COVID,” said Carole Johnson, White House coronavirus testing coordinator. “We look forward to working with schools to implement this exciting new program.”
Cardona visited a Meriden elementary school in early March with first lady Jill Biden to highlight strategies helping schools teach safely during the pandemic.
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Gov. Ned Lamont’s new plan for rebuilding Connecticut’s sagging unemployment fund would require bigger businesses to pay a larger share, with increased tax relief for many smaller businesses.
It would also sharply reduce the number of people who can draw unemployment benefits while receiving severance payments after losing their jobs.
On Wednesday, the Finance, Revenue and Bonding Committee discussed how to rebuild Connecticut’s Unemployment Insurance Trust Fund, which the state drained during the COVID-19 pandemic by paying out benefits across 1.4 million claims over the past 12 months.
After blowing through $7.5 billion over 12 months paying out jobless benefits, Lamont wants to rebuild the fund through changes that would have bigger businesses paying a larger share — with many small businesses to see their taxes cut if the Connecticut General Assembly adopts the recommendations.
Lamont wants to expand the “taxable wage base” cap used to compute trust fund contributions. The governor’s policy director Jonny Dach told legislators on Wednesday that would shift some of the burden of rebuilding the fund from the backs of small businesses to larger employers picking up more of the tab.
Restaurants alone, Dach said, would shave 35 percent on average off their unemployment inrecession. surance taxes.
The Connecticut Department of Labor lists some 580,000 people by Social Security number who have received unemployment benefits, with an unspecified number having cycled on and off assistance as dictated by repeat interruptions in their regular work income.
The DOL has taken out $635 million in federal loans to date to continue paying benefits to state residents, with more than 200,000 receiving assistance as of this week.
Dach described Connecticut as “bottom of the barrel” nationally as of January 2020 with regard to the solvency of its Unemployment Insurance Trust Fund, even after 10 “pretty good years” of contributions after the 2009 It took Connecticut six years to repay the $1.25 billion it borrowed after the Great Recession, including interest of $85 million it incurred.
“The program has to be funded — there’s no such thing as a free lunch,” Dach said. “If you pay out a dollar in benefit, it means you are going to collect that dollar at some point from the employers.”
Tinkering with benefits
But a freebie was served up for one group during the pandemic — independent workers who under preexisting federal law do not have to pay unemployment insurance taxes.
Those earners were allowed to draw benefits for the first time under last year’s Coronavirus
Aid, Relief and Economic Security Act, which sought to ease the shock to the U.S. economy caused by mass business closures. As of mid-February, the U.S. Department of Labor reported more than 38,000 independent workers in Connecticut receiving unemployment benefits.
Across the board, Connecticut claimants are able to draw a maximum $667 weekly benefit at present, with the CARES Act authorizing a $600 “plus-up” for stretches of 2020 that has since been reduced to $300 through this August.
Dach said both fund solvency and commonsense were behind the proposed rule that would prevent people putting in for