Citing Need for Local Control, Santa Clara Co. Declines to Take Part in State Vaccination Plan

Santa Clara County officials say they refuse to join the state’s new centralized vaccine distribution plan that will be run by Oakland-based health insurance giant Blue Shield.

During the county Board of Supervisors meeting on Tuesday, County Executive Jeff Smith said California’s new program, known as the Statewide Vaccination Network, left him with “significant concerns.”

The Statewide Vaccination Network, announced on March 1, relegates state vaccine distribution to Blue Shield, creates a central site for California residents to book vaccine appointments at and requires a participating county to follow in suit when the state expands vaccine eligibility.

Currently, counties can make their own decisions regarding vaccine eligibility.

Blue Shield would also have the ability to make recommendations to the state about divvying up vaccine doses to better target disproportionately impacted communities.

Counties would still be involved in operating vaccination sites, but Smith said the Blue Shield contract would make the county obsolete in vaccination decisions—putting “statewide priorities over local needs.”

“It eliminates local control, puts our local equity efforts at risk,” Smith said. “It means that we would not be able to operate as many small pop-ups and focused sites on particular communities.”

Creating pop-up vaccination sites in hard-hit communities is a central part of the county’s efforts to create equitable vaccination opportunities for residents. Smith also said that the plan adds unnecessary layers of bureaucracy without making vaccinations easier or solving the county and state’s major problem—more vaccine supply.

“We have through the [county] website an easy, accessible way for people to sign up for appointments,” Smith said, noting that there is not much difference between the county’s site and the state’s My Turn counterpart.

The county also collects and reports vaccine data in a “robust manner” and makes that data public with daily updates, Smith said. “So, we have that infrastructure in place,” Smith said. “With respect to Santa Clara County, our impediment and our issue is purely one of vaccine supply. And there's no indication that in any way that supply issue is addressed through the [contract with Blue Shield].”

When the plan was announced, state officials said the distribution system would accelerate vaccine roll out and unify the state in vaccine eligibility, with the goal of having 4 million shots of vaccine a week by the end of April.

But Smith said the county has lost allocations since the plan was announced.

This week, the county received 3,000 fewer doses than the week of March 1 through 5, according to County Health Officer Dr. Sara Cody’s weekly Covid update.

County Counsel James Williams also noted conflict of interest concerns over contracting essential state government functions to a private third party.

By doing so, the state could be in violation of State Code 1090, which prohibits agencies that contract with the state to have any financial interest in any contract.

“It raises concerns certainly under a number of statutes that affect contracting but more generally, it is a challenging type of approach to take,” Williams said.

And having a health insurance titan collect private health data would make residents uncomfortable, and potentially prevent them from getting the vaccine.

It creates a “significant problem with confidentiality and trust because many of our residents do not trust the government or others to treat their information with care and security,” Smith said.

So far, only Kern County and dozens of providers, which would equate to more than 1,000 vaccination sites, have joined the Statewide Vaccination Network.

Smith said because of county concerns, the state may be “giving up on the concept” of asking counties to contract directly with Blue Shield, but private health providers may still be required to partner.

The California State Department of Public Health said the state is working with counties to finalize language to outline their roles as vaccine providers, but did not confirm any changes or lack thereof to the state’s vaccine distribution plan.

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