Legislature Examines State Rollout of COVID-19 Vaccines, Considers Public Health Infrastructure Funding
This week, the California State Senate and Assembly convened several hearings to examine the state’s rollout and administration of COVID-19 vaccines, as well as consider investments for the state’s public health infrastructure. Below, we detail each of the hearings.
Assembly Sub. 1 Assesses Vaccine Administration, Hears CHEAC Budget Requests
On Monday, the Assembly Budget Subcommittee No. 1 on Health and Human Services (HHS) convened its first subcommittee hearing of the year to examine proposed early action investments in the areas of the Emergency Medical Services Authority (EMSA), the Office of Statewide Health Planning and Development (OSHPD), the California Department of Public Health (CDPH), and the Department of Health Care Services (DHCS).
Notably, the subcommittee received an overview of the CDPH budget and reviewed CDPH’s pandemic response, including investments related to workplace outbreak reporting, infectious disease modeling, and personal protective equipment (PPE) funding. Numerous representatives from CDPH, including Director and State Public Health Officer Tomás Aragón, Chief Deputy Director Susan Fanelli, and State Epidemiologist Dr. Erica Pan, discussed the department’s role and performance in coordinating and responding to the ongoing COVID-19 pandemic. Among the topics covered by CDPH representatives were state industry guidance, COVID-19 vaccine allocation and administration, hospital surge activities, impacts on populations disproportionately affected by COVID-19, and epidemiological surveillance.
Madera County Public Health Director Sara Bosse presented to the subcommittee to share a local perspective on pandemic emergency response activities, including case investigation and contact tracing efforts, partnerships with health providers and community-based organizations, and vaccine administration. Director Bosse highlighted ongoing challenges being experienced by local health departments statewide in responding to the pandemic, such as data quality and access, public health workforce availability, and vaccine supply and administration efforts, among others.
Director Bosse and CHEAC Executive Director Michelle Gibbons, among others, presented budget requests for two public health infrastructure investments. The requests, sponsored by CHEAC, CSAC, UCC, RCRC, HOAC, and SEIU California, seek $200 million ongoing General Fund for public health infrastructure and workforce and $3.45 million one-time General Fund for a statewide public health infrastructure study. Director Bosse highlighted the urgent need for ongoing and sustainable funding for public health infrastructure to ensure a trained and adequate workforce and ensure the continuity of non-pandemic-related local health department programs and services.
Subcommittee members had the opportunity to ask questions of presenters, which largely focused around COVID-19 vaccine allocation and distribution, vaccine eligibility, the forthcoming third-party administrator (TPA) framework, vaccine equity and attempts to reach underserved populations, and ongoing challenges with data and state data systems. All items were held open for action at a later date.
Joint Assembly Committees Hear Local and State Perspectives on COVID-19 Distribution
On Wednesday, the Assembly Accountability and Administrative Review Committee (A&AR) and the Assembly Emergency Management Committee (EM) convened a joint oversight hearing to examine California’s COVID-19 vaccine distribution. The chairs of each committee, Assembly Member Cottie Petrie-Norris (A&AR) and Freddie Rodriguez (EM), both emphasized at the start of the hearing their goal was to understand California’s vaccine rollout strategy and how recent changes will impact existing local vaccine operations.
The first panel was comprised of Yolo County Health Officer Dr. Amy Sisson and Los Angeles County Department of Public Health’s Chief Science Officer, Dr. Paul Simon. Dr. Sisson discussed how vaccines are allocated and distributed at the local level by health departments. She illustrated the problems with state vaccine data and recommended that if the state moves to a third-party administrator (TPA), data quality needs to be improved and local health departments (LHD) must be engaged in decisions on how to distribute vaccine to vulnerable communities. Dr. Simon emphasized the biggest issue to date is the scarcity of vaccine supply. He also recommended that as the state moves to the third-party administrator, LHDs must be allowed to identify provider networks within their communities to ensure the equitable distribution of vaccine, that additional state and federal revenues are necessary to support local efforts to slow the spread of the virus, to allow LHDs to have ongoing and timely access to accurate data to assist local planning and evaluation, and to provide consistent and coordinated messaging from the state to help manage the public’s expectations and to maintain public trust.
Following the local perspective panel, several representatives spoke on behalf of the state’s vaccine rollout efforts. Panelists included CDPH Director, Dr. Tomás Aragón, Government Operations Secretary, Yolanda Richardson, TPA Project Coordinator, Marta Green, CalOES representatives, Tina Curry and Lori Nezhura, and Civic Engagement and Strategic Partnerships Director, Maricela Rodriguez. Dr. Aragón discussed the state’s approach to vaccination efforts across the state and delved into vaccine prioritization categories. Secretary Richardson talked about the rationale for creating a single statewide network for vaccine distribution through the TPA as well as the creation of the MyTurn vaccine eligibility and appointment system. Other panelists discussed the TPA, state supports for vaccination clinics including PPE and staff, and the state’s vaccine community engagement and education plan.
Members of both committees expressed concerns with the TPA, vaccine prioritization categories, and vaccine allocations. Assembly Member Petrie-Norris concluded the hearing with three recommendations to the state including setting clear and achievable goals for the public and partners, asking that state plans or criteria not be changed as it creates confusion, and requesting improved communications with counties and statewide/local partners.
Senate Sub. 3 Examines COVID-19 Response, CDPH Budget Items
Today, the Senate Budget & Fiscal Review Subcommittee No. 3 on Health and Human Services (HHS) convened a hearing to examine proposed investments in the California Department of Public Health (CDPH), as well as to receive an update on the state’s ongoing public health response to the COVID-19 pandemic. The subcommittee considered various investments proposed by CDPH, including infectious disease modeling, COVID-19 workplace outbreak reporting, personal protective equipment (PPE) availability, and books for low-income children.
The subcommittee received updates from CDPH on the current status of COVID-19 in California, prevention and response activities associated with the pandemic, COVID-19 testing capacities, the state’s vaccine distribution processes and systems, case identification and contact tracing supports, pandemic preparedness efforts, and funding implications for the pandemic response. The hearing additionally featured a panel of representatives to provide an overview of local- and sector-specific pandemic response activities. CHEAC Executive Director Michelle Gibbons and HOAC Executive Director Kat DeBurgh discussed local health departments’ activities in responding to the pandemic, resource needs associated with the continued pandemic response, and gaps in readiness and resources for a future pandemic. Other witnesses representing hospitals, clinics, and skilled nursing facilities discussed the pandemic’s impacts on their operations, and the California Pan-Ethnic Health Network (CPEHN) and SEIU California additionally discussed impacts on their consumers and communities.
The hearing agenda is available here.