The Mercury News

State should deliver vaccines to seniors, disabled

- By George Skelton George Skelton is a Los Angeles Times columnist.

They’re going to home deliver COVID-19 vaccinatio­ns to shut-in seniors and people with disabiliti­es. That’s what they say, anyway. We’ll see.

Great idea. The Newsom administra­tion’s follow-through on its ideas, however, hasn’t always been that great.

I wrote last month that if the federal government can deliver mail to our homes daily and if the city can pick up our garbage, then California should be able to provide home delivery for vaccinatio­ns — at least to seniors.

Surprise: The state actually wants to do it.

It wants someone else to do it, anyway. And in truth, that’s the best way for the state to get most things done — pay someone else to do it.

Home delivery of COVID-19 shots is a goal tucked into a contract awarded by the Newsom administra­tion to Blue Shield of California for expanding and coordinati­ng vaccinatio­ns throughout the state. Blue Shield can bill the state up to $15 million for outof-pocket costs.

Kaiser Permanente is expected to sign a separate contract with the state to operate a vaccinatio­n program for its 9 million California health care members while helping to inoculate “hard-to-reach and disproport­ionately impacted population­s,” according to an earlier letter of intent.

Gov. Gavin Newsom thought the vaccine distributi­on system needed more centraliza­tion because too many locally managed operations were sluggish and inconsiste­nt.

“Everybody came together looking at what’s working, what’s not working, and we identified two partners in particular, two nonprofits, Kaiser and Blue Shield,” Newsom said of the deals. “They have the kind of scale, they have the capacity, they have the allocation-distributi­on mindset we were looking for.”

The Blue Shield contract gives the insurance behemoth vast powers to oversee California’s distributi­on of vaccine doses.

It will be allowed to choose which providers administer vaccine and prioritize distributi­on. Its goal is to more than double the current weekly number of shots to 3 million by March 1 and 4 million by April 30.

But that ambitious goal of rapidly increasing inoculatio­ns seems in potential conflict with the concept of relatively slow home delivery. When the chips are down, the state and Blue Shield are very likely to opt for big vaccinatio­n numbers over the pokey inoculatio­n of homebound seniors and people with disabiliti­es.

Yes, both theoretica­lly can be accomplish­ed. But the higher the vaccinatio­n numbers are run up, the more politicall­y favorable headlines are generated. That’s especially coveted by a governor who’s threatened with being recalled.

So this isn’t a done deal, regardless of noble intentions.

The Blue Shield contract is vague on home delivery. It merely obligates the company to arrange for the delivery of “vaccines to people who are homebound or suffering from illnesses/disabiliti­es that make it unsafe or prohibitiv­ely difficult for them to visit a vaccine provider for a vaccinatio­n.”

Newsom told reporters Tuesday that the Blue Shield contract would “be implemente­d over the course of the next number of weeks.”

Seniors are the most at risk of dying or at least requiring hospitaliz­ation if hit by the virus. Getting them inoculated means not only saving their lives, but sparing hospital beds and ICU facilities for other people and illnesses. It’s win-win all around.

People over 65 make up less than 16% of the California population, but they’ve accounted for more than 74% of the COVID-19 deaths, according to the state. Those 80 and over comprise less than 4% of the population but amount to 40.5% of virus deaths.

Of the people who have received at least one shot of vaccine in California, about 55% are at least 65.

But an estimated one-third of seniors over 65 no longer drive cars. Not all have adult sons or daughters who can drive them to a vaccinatio­n site.

And even if they get there, many can’t handle standing in line if that’s required.

That’s assuming they can even get an appointmen­t. Many are technologi­cally challenged and can’t handle the convoluted provider websites. And the phone lines are often jammed.

“The point is this: Remember the old get-out-the vote efforts on election day, before there were so many mail ballots, with people going door to door, offering rides to the polls?” asks Anthony Wright, executive director of Health Access California.

“If you’re going through all that trouble, it may be worth just having a nurse come along and administer the vaccine directly at home. It would be more efficient.”

Home delivery hasn’t happened yet, except in a few places where it’s handled mostly by volunteers.

But it’s on the state’s agenda. Senior and disability activists need to fight for it and push the logical idea into reality.

 ?? THE ASSOCIATED PRESS ?? The question is whether Gov. Gavin Newsom’s follow-through on vaccinatio­n plans will work.
THE ASSOCIATED PRESS The question is whether Gov. Gavin Newsom’s follow-through on vaccinatio­n plans will work.

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