County to fine providers over testing
Santa Clara County health officials announced a newly revised health order on Wednesday that enacts fines of up to $5,000 per violation for private health care providers that do not make coronavirus testing accessible and fast enough for their patients.
The revised order, which takes effect Sept. 25, adds to the county’s previous June health order that requires large health care providers, including Kaiser Permanente and Sutter Health, to increase testing.
The newly revised order marks a notable and unusual step by a county health department to apply more pressure on large private health care providers to conduct more testing, or face financial consequences if they do not comply. Testing plays a critical role in controlling the virus, particularly as the county begins to reopen businesses and schools.
County health officials have said for months that the public health system is shouldering much of the burden of testing and that private health care providers have not stepped up to do their share of testing.
Santa Clara County supervisors and mayors of several cities in the county specifically cited anecdotal examples from constituents who had difficulty getting tested at Kaiser and Sutter Health Palo Alto Medical Foundation, two of the largest health care providers in the region. When residents are not able to get tested at their own health care provider, they often go to county
provided testing sites that offer free testing.
Under the revised order, health care providers must provide a coronavirus test by the next business day for people who have been exposed to the virus or who are symptomatic, and within three days for asymptomatic people like essential workers who need routine testing. Providers must return test results within three days. The order does not require health care providers to meet these requirements if the person seeking testing is part of the “worried well” — someone who is not an essential worker, does not have symptoms, does not believe they have been exposed and has not been referred for testing by public health because of a potential exposure.
“There is no excuse,” said Supervisor Joe Simitian. “If it’s hard, if there are supply chain problems, step up. If there’s a need for greater capacity, then build it, buy it or pool your tests.”
Providers that do not meet these requirements could face fines of up to $5,000 for each time a patient is denied testing or cannot get a test fast enough, and the fines can accrue daily.
“Those could potentially add up if there’s substantial, widespread noncompliance,” said County Counsel James Williams. He encouraged residents to report potential violations to a website established by the county to enforce the order, SCCcovidconcerns.org.
The county has provided the bulk of testing, even though large private health care systems provide care to the majority of residents, county officials said. During the week of Aug. 31 to Sept. 6, the county conducted 13,072 tests, compared with Kaiser’s 4,261, Stanford’s 3,243, Sutter PAMF’s 1,426, El Camino Health’s 679 and HCA Healthcare’s 633, according to county data.
Kaiser said it has invested in expanding coronavirus testing, including opening a lab in Berkeley. The health care system, which has 4.4 million members in Northern California, is poised to reach testing capacity of 12,000 tests a day in Northern California by the end of September — an increase of 700% since February.
“Everyone, including Kaiser Permanente, agrees more testing needs to be done throughout our communities to address the pandemic and we are committed to making testing timely and accessible for our members,” Irene Chavez, senior vice president and area manager of Kaiser Permanente San Jose, said in a written statement. “Kaiser Permanente has made, and continues to make, major investments in equipment, resources and people to expand our COVID testing capacity.”
Sutter directed questions to the Hospital Council of Central and Northern California, which represents hospitals in Northern and Central California, including Sutter and Kaiser.
Bryan Bucklew, president and CEO of the council, said some of Santa Clara County’s figures on how many tests hospitals are doing are undercounted by up to several hundred tests a week. He said private hospitals are doing as much testing as they can, and that they do not always have access to the testing supplies that public health agencies do.
“Hospitals continue to want to test,” Bucklew said. “The private hospital labs have never been set up to do largescale community testing. I think hospitals have done a great job to redeploy (resources) to do as much testing as we can. There are still challenges in the supply chain.”