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Supervisors to consider requiring health care systems to provide vaccination plans

Officials seek a comprehensive view of how many vaccines are being given out, to whom and when

Yvonne Guereca, a pharmacy technician at El Camino Hospital, dilutes each vial of Pfizer-BioNTech COVID-19 vaccine with an injection of 0.9% sodium chloride. Photo by Federica Armstrong.

UPDATE: By a unanimous vote, the Santa Clara County Board of Supervisors supported a proposal for large health care systems in the county to provide written plans and timelines for COVID-19 vaccine distribution at its Jan. 12 meeting.

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Santa Clara County's Board of Supervisors will consider directing staff to create an urgency ordinance on Tuesday that would require large health care systems to produce a written plan and timeline for administering the COVID-19 vaccine to county residents. The administration and County Counsel would present the board with the ordinance at the Jan. 26 meeting.

The goal of the ordinance is to bring the county's health care sector, including private hospitals and clinics, on board so officials have a comprehensive view of how many vaccines are being given out, to whom and when.

The ordinance would augment a Jan. 7 Public Health order that requires vaccination providers in the county to share information on an ongoing basis and to prepare vaccination plans by Feb. 1.

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Under the health officer's order, large health care systems must submit comprehensive plans that include: how they intend to provide vaccines to all of their primary care patients as they become eligible; how they will create vaccine-administration sites; communication plans to inform their patients when and where they can receive vaccines; the anticipated number of vaccine appointments; and a timeline for achieving the full vaccination of their patients and how they will avoid "wasting" vaccine doses when there are not enough patients receiving them within a designated tier on any particular day.

Supervisor Joe Simitian, who chairs the board's health and hospital committee, and board President Cindy Chavez said during a webinar on Monday that they want to be sure the currently fragmented protocols for various health sectors are brought together.

The health care entities would be required to share these plans with the Board of Supervisors and the public. The plans would include information on how people will find out about their ability to get vaccinated, and how vaccines will be distributed. The medical facilities also would have contingency plans for unexpected situations, such as broken freezers or extra doses of thawed vaccines so that they can be administered before they expire.

Simitian and Chavez said they are also concerned that many people might fall through the cracks even with the individual health providers' plans. The urgency ordinance would include requirements for plans related to people who don't currently have a health care provider — the "missing middle," Simitian said.

The supervisors said they wanted to avoid the problems they saw with the COVID-19 testing, when there were months of back-and-forth discussions that slowed down the ramp up.

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Not all health care providers approached the same requirements equally, requiring a mandate from the board to test patients. Simitian said he hopes the same won't happen with the vaccines. Unlike the testing, health providers are used to giving vaccinations as part of their overall mission; they didn't always see testing as part of their responsibilities, he said.

"Given the dire state of the pandemic and the hope for vaccination, our health care systems cannot afford to repeat these patterns. We recognize that large health care systems could play an even greater role in vaccine distribution, and detailed plans and timelines that are public and coordinated can reduce confusion, instill confidence and, most importantly, get the job done in a timely, fair, efficient, and life-saving fashion," Simitian and Chavez said in a joint proposal to the board.

"We can't afford to lose a month; we can't afford to lose a week; we can't afford to lose a single day," Simitian added on Monday.

Without coordination and tracking, the state's current patchwork system creates potential disparities in the quality and quantity of information provided to the public and risks inconsistent or incomplete rollout of vaccinations, the supervisors said

Entities with a nexus in multiple counties, such as Kaiser Permanente and Palo Alto Medical Foundation, for example, receive their vaccine allotments directly from the state; hospitals in the Veterans Affairs Health Care System receive the vaccines through the federal supply chain; CVS and Walgreens drug stores administer the vaccines at skilled nursing and long-term care facilities for the Centers for Disease Control and Prevention; and private and nonprofit providers, such as Stanford Health Care and El Camino Health, receive their vaccines from the county.

"We need a very rigorous framework so people know when it's their turn to get vaccinated," Chavez said.

Simitian noted that the state's seven phases and tiers for rolling out the vaccine have also created challenges. "People should not be waiting for the last person in a tier" to start receiving their vaccine, he said.

On Monday, Gov. Gavin Newsom said the state is addressing some of these concerns, noting that state health leaders are working to expand the pool of recipients and the tiers so that there will be a smoother and more rapid rollout. The state expects to reach its 10-day goal of 1 million administered vaccines by this weekend, he said.

The state and the county are also setting up more mass testing sites. Santa Clara County has a site at the county fairgrounds and has had a number of offers, including from Levi's Stadium, to set up more, Chavez said.

Find comprehensive coverage on the Midpeninsula's response to the new coronavirus by Palo Alto Online, the Mountain View Voice and the Almanac here.

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Supervisors to consider requiring health care systems to provide vaccination plans

Officials seek a comprehensive view of how many vaccines are being given out, to whom and when

by / Palo Alto Weekly

Uploaded: Wed, Jan 13, 2021, 1:48 pm
Updated: Thu, Jan 14, 2021, 2:02 pm

UPDATE: By a unanimous vote, the Santa Clara County Board of Supervisors supported a proposal for large health care systems in the county to provide written plans and timelines for COVID-19 vaccine distribution at its Jan. 12 meeting.

---

Santa Clara County's Board of Supervisors will consider directing staff to create an urgency ordinance on Tuesday that would require large health care systems to produce a written plan and timeline for administering the COVID-19 vaccine to county residents. The administration and County Counsel would present the board with the ordinance at the Jan. 26 meeting.

The goal of the ordinance is to bring the county's health care sector, including private hospitals and clinics, on board so officials have a comprehensive view of how many vaccines are being given out, to whom and when.

The ordinance would augment a Jan. 7 Public Health order that requires vaccination providers in the county to share information on an ongoing basis and to prepare vaccination plans by Feb. 1.

Under the health officer's order, large health care systems must submit comprehensive plans that include: how they intend to provide vaccines to all of their primary care patients as they become eligible; how they will create vaccine-administration sites; communication plans to inform their patients when and where they can receive vaccines; the anticipated number of vaccine appointments; and a timeline for achieving the full vaccination of their patients and how they will avoid "wasting" vaccine doses when there are not enough patients receiving them within a designated tier on any particular day.

Supervisor Joe Simitian, who chairs the board's health and hospital committee, and board President Cindy Chavez said during a webinar on Monday that they want to be sure the currently fragmented protocols for various health sectors are brought together.

The health care entities would be required to share these plans with the Board of Supervisors and the public. The plans would include information on how people will find out about their ability to get vaccinated, and how vaccines will be distributed. The medical facilities also would have contingency plans for unexpected situations, such as broken freezers or extra doses of thawed vaccines so that they can be administered before they expire.

Simitian and Chavez said they are also concerned that many people might fall through the cracks even with the individual health providers' plans. The urgency ordinance would include requirements for plans related to people who don't currently have a health care provider — the "missing middle," Simitian said.

The supervisors said they wanted to avoid the problems they saw with the COVID-19 testing, when there were months of back-and-forth discussions that slowed down the ramp up.

Not all health care providers approached the same requirements equally, requiring a mandate from the board to test patients. Simitian said he hopes the same won't happen with the vaccines. Unlike the testing, health providers are used to giving vaccinations as part of their overall mission; they didn't always see testing as part of their responsibilities, he said.

"Given the dire state of the pandemic and the hope for vaccination, our health care systems cannot afford to repeat these patterns. We recognize that large health care systems could play an even greater role in vaccine distribution, and detailed plans and timelines that are public and coordinated can reduce confusion, instill confidence and, most importantly, get the job done in a timely, fair, efficient, and life-saving fashion," Simitian and Chavez said in a joint proposal to the board.

"We can't afford to lose a month; we can't afford to lose a week; we can't afford to lose a single day," Simitian added on Monday.

Without coordination and tracking, the state's current patchwork system creates potential disparities in the quality and quantity of information provided to the public and risks inconsistent or incomplete rollout of vaccinations, the supervisors said

Entities with a nexus in multiple counties, such as Kaiser Permanente and Palo Alto Medical Foundation, for example, receive their vaccine allotments directly from the state; hospitals in the Veterans Affairs Health Care System receive the vaccines through the federal supply chain; CVS and Walgreens drug stores administer the vaccines at skilled nursing and long-term care facilities for the Centers for Disease Control and Prevention; and private and nonprofit providers, such as Stanford Health Care and El Camino Health, receive their vaccines from the county.

"We need a very rigorous framework so people know when it's their turn to get vaccinated," Chavez said.

Simitian noted that the state's seven phases and tiers for rolling out the vaccine have also created challenges. "People should not be waiting for the last person in a tier" to start receiving their vaccine, he said.

On Monday, Gov. Gavin Newsom said the state is addressing some of these concerns, noting that state health leaders are working to expand the pool of recipients and the tiers so that there will be a smoother and more rapid rollout. The state expects to reach its 10-day goal of 1 million administered vaccines by this weekend, he said.

The state and the county are also setting up more mass testing sites. Santa Clara County has a site at the county fairgrounds and has had a number of offers, including from Levi's Stadium, to set up more, Chavez said.

Find comprehensive coverage on the Midpeninsula's response to the new coronavirus by Palo Alto Online, the Mountain View Voice and the Almanac here.

Comments

Vaccine sites NOT bureaucracy!!!
Registered user
Sylvan Park
on Jan 13, 2021 at 11:04 pm
Vaccine sites NOT bureaucracy!!!, Sylvan Park
Registered user
on Jan 13, 2021 at 11:04 pm
7 people like this

Just set up drive thru vaccination sites at Levy’s, Shoreline, Great America, Stanford, Google parking, Avaya. Etc etc. we KNEW this was coming. County has had 10 MONTHS to plan. This is not rocket science. Supervisors are creating bureaucracy!!


MV neighbor
Registered user
Old Mountain View
on Jan 14, 2021 at 12:17 am
MV neighbor, Old Mountain View
Registered user
on Jan 14, 2021 at 12:17 am
Like this comment

I think getting these big health plans to share some information would be great. The various sites that are opening up over 65 vaccinations are saying that people covered by Kaiser and PAMF are not eligible to be vaccinated there (i.e. see El Camino website and Santa Clara health department vaccination information), but Kaiser still has no information available ... number listed by county for Kaiser members to call is just their general appointments telephone tree. Over 75 members are not getting emails on how to make appointments, let alone over 65...maybe PAMF is doing more. For flu vaccinations, Kaiser had dedicated website to make appointments, but no clues whether they will do it for covid vaccinations or what they plan...


Dan Waylonis
Registered user
Jackson Park
on Jan 14, 2021 at 3:50 pm
Dan Waylonis, Jackson Park
Registered user
on Jan 14, 2021 at 3:50 pm
2 people like this

CA's response has been reprehensible. After frontline medical workers and nursing home residents have their chance, send 90% of the vaccinations to CVS and Walgreens. They will distribute for free since it will lead to increased foot traffic in their stores.


Tal Shaya
Registered user
another community
on Jan 15, 2021 at 7:50 am
Tal Shaya, another community
Registered user
on Jan 15, 2021 at 7:50 am
5 people like this

They had nine months to prepare. They knew we had to hit the ground running, but they spent the time pointing fingers at Washington and playing political games. Gee, do you think maybe we should have a VACCINE PLAN by now? Dr. Sara Cody should resign. There is no excuse for this dereliction of duty.


Victor Bishop
Registered user
Another Mountain View Neighborhood
on Jan 15, 2021 at 2:57 pm
Victor Bishop, Another Mountain View Neighborhood
Registered user
on Jan 15, 2021 at 2:57 pm
7 people like this

The buck stops with Cody and Smith. They are in charge. They had months to get their acts together. Maybe cody should spend less time checking to make sure businesses have 20 pieces of paper on their windows and get to work on this. And she can stop wasting time crying


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