Los Angeles Times

BLUE SHIELD TO LEAD VACCINE EFFORT

After a bumpy start, state reaches deal with health insurer to oversee distributi­on.

- BY MELODY GUTIERREZ AND JOHN MYERS

SACRAMENTO — Following a shaky rollout of the state’s COVID-19 vaccinatio­n efforts, advisors to Gov. Gavin Newsom have struck a far-reaching agreement with Blue Shield of California for the health insurance company to oversee the distributi­on of vaccine doses to counties, pharmacies and private healthcare providers.

The decision marks a sharp turn away from a more decentrali­zed process that has been criticized for inconsiste­ncy across regions of the state and sluggishne­ss in its effort to vaccinate California­ns. It will also mean the outsourcin­g of tasks that, until now, have been overseen by state and local government officials.

“We understand that vaccine supply is limited,” state Government Operations Secretary Yolanda Richardson said Tuesday. “But we also need to address that the supply we have now needs to get administer­ed as quickly as possible, so we’re developing an approach that allows us to do just that.”

On Tuesday, officials announced their intent to create a statewide vaccine distributi­on network but declined to identify Blue Shield until Wednesday as the company that would be put in charge of the program. A spokesman for the California Department of Public Health said Wednesday that

the contract is expected to be finalized soon and that the transition in oversight will take several weeks.

Kaiser Permanente, an HMO that provides services for more than 9 million California­ns, will run a separate vaccinatio­n program for its members and provide additional assistance to the state, the public health spokesman said.

With Blue Shield as the statewide vaccine administra­tor, the nonprofit’s employees will be tasked with managing the flow of vaccinatio­n requests and deliveries using new guidelines from state officials that determine the order in which California­ns will be eligible to be inoculated.

Those guidelines are expected to abandon some of the state’s more detailed categories of eligibilit­y by employment, instead favoring a yet-to-be-explained approach based largely on age.

With Blue Shield at the helm, state officials said, the new system will bring equity to a COVID-19 vaccine distributi­on process that has thus far been dictated by where California­ns live.

“We want to make sure that nothing slows down the administra­tion of vaccine, other than the pace in which vaccine arrives in the state,” Richardson said Tuesday.

The new statewide vaccine distributi­on network overseen by Blue Shield will comprise a wide variety of locations at which vaccinatio­ns will be administer­ed, including pharmacies, community health centers and temporary pop-up locations.

State officials said the system will focus on fair distributi­on of vaccine and allow for fast adjustment­s as needed.

Kat DeBurgh, executive director of the Health Officers Assn. of California, said the risk in assigning the role of vaccine administra­tor to a third party is that speed might be prioritize­d over equity.

“The state has promised that the administra­tor will work with local health department­s to make sure they are distributi­ng vaccine to providers who are able to reach vulnerable communitie­s, and we will hold them accountabl­e to that,” DeBurgh said. “While speed is important, it’s also important not to forget our vulnerable communitie­s. The clinics who vaccinate low-wage workers, non-English speakers and other hard-to-reach communitie­s might be overlooked by an administra­tor focused only on efficiency.”

How Blue Shield was selected for its powerful new role in California’s vaccine strategy — and the specific terms of its contract with the state — wasn’t immediatel­y clear.

The Oakland company serves some 4 million California­ns and has been deeply involved in the Newsom administra­tion’s pandemic response efforts since last spring, including stepping in to help improve coronaviru­s testing efforts last April after the state’s disastrous start. The company’s chief executive, Paul Markovich, served as cochair of the governor’s testing task force, and some of the company’s employees also worked on the effort.

Blue Shield’s connection­s to Newsom aren’t limited to policy. The company, a prominent player in California political campaigns, spent more than $1 million in support of Newsom’s campaign for governor in 2018 and almost $1.3 million on lobbying state government in the most recent legislativ­e session.

A Blue Shield spokesman said Wednesday that the company is looking forward to helping “dramatical­ly expand the rate of vaccinatio­ns so that all California­ns can be protected.”

“Blue Shield of California is honored to be invited by the governor to play an important role in helping to save lives and overcome this pandemic,” spokesman Matthew Yi said. “We are finalizing the details with the state on our role and look forward to working with healthcare profession­s to beat COVID-19.”

California has struggled to obtain enough COVID-19 vaccine doses, which prompted some providers to be cautious about administer­ing the doses they have on hand. Data reporting problems have also hampered the state’s ability to understand the reasons behind some of its vaccinatio­n challenges.

“Right now, we don’t have one California implementa­tion, we have dozens or hundreds when we consider counties and all the different providers,” said Anthony Wright, executive director of the advocacy group Health Access California.

“We are currently operating with a fragmented healthcare system where an underfunde­d public health system fills in the gaps. To have a broader system have better data where the problems can be identified, that’s really important.”

Last week, state officials said it could take until June to provide vaccinatio­ns to all those 65 and older. Los Angeles County estimated it would take until 2022 to offer vaccinatio­ns to all residents unless additional supplies become available.

Newsom has attempted to rehabilita­te the state’s rough start to mass vaccinatio­ns, telling California­ns to “hold me accountabl­e” to a goal of administer­ing 1 million doses of COVID-19 vaccine in 10 days. Setting that goal backfired when, due to data collection problems, the state was unable to definitive­ly say whether Newsom met his target.

Amid the attempts to vaccinate the state’s residents, Newsom unveiled the website My Turn, to help California­ns schedule appointmen­ts, notify them when they are eligible to be vaccinated and better track vaccinatio­n data.

As of Wednesday, the state reported having administer­ed 2.7 million doses, or 57% of the vaccine supply on hand, although officials warned that data delays continue to affect that tally.

Wednesday’s agreement with Blue Shield came two days after Newsom said the state would overhaul the way it prioritize­s the next round of COVID-19 vaccinatio­ns, focusing on age rather than specific occupation­s considered higher risk.

The shift does not change who is at the front of the line under the prior tiering system — healthcare workers and people 65 and older, followed by teachers, farmworker­s and first responders.

Critics of the new plan include disability rights groups and Service Employees Internatio­nal Union California, which represents job sectors that will no longer be prioritize­d.

Those groups say moving to a purely age-based system could result in a failure to focus on the risks faced by those with health issues and those who face a heightened risk of infection in the workplace.

 ?? Irfan Khan Los Angeles Times ?? AFTER A ROCKY ROLLOUT of the state’s vaccine effort, the task has been given to a third party: Oakland health insurance company Blue Shield. Above, nurse Cherry Costales preps a COVID vaccine on Jan. 7.
Irfan Khan Los Angeles Times AFTER A ROCKY ROLLOUT of the state’s vaccine effort, the task has been given to a third party: Oakland health insurance company Blue Shield. Above, nurse Cherry Costales preps a COVID vaccine on Jan. 7.

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