LOS ANGELES -- Facing widespread criticism for its slow vaccine rollout, California is revamping its delivery system by centralizing its hodgepodge of county systems and streamlining appointment sign-up, notification, and eligibility for its 40 million residents.
A new statewide secretary will spearhead operations and delivery, working with private third party administrators, as yet unnamed, to decide where the state’s supply of vaccine should go when the federal supply ramps up to meet demand, Gov. Gavin Newsom announced Tuesday.
A new sign-up tool will also allow the state to better track where vaccines have gone and who has been vaccinated, while also allowing residents to schedule an appointment when it's their turn.
California has been dinged for vaccinating so few people even amid a national vaccine shortage that appears to be the main bottleneck, administering about 2.4 million of 4.5 million doses shipped. At the same time, confused residents are clamoring for more information on when they might be vaccinated, frustrated by eligibility rules that vary by county and by hospital system.
Yolanda Richardson, newly appointed secretary of the government operations agency, said at a Tuesday briefing that this new system is “about California being prepared to make sure that we can get out the vaccine when more supply is available.”
Several of the state's 58 counties have pressed for more vaccine, saying they can inoculate far more people if they had a steadier and larger supply. Fresno County, for example, said it requested 38,000 doses last week but received only 8,000, and had to pause vaccinating new people because they feared not having enough for required second shots.
The state has said it also does not know how much vaccine it will receive from the federal government, and hopes that will change with a new president in the White House.
Richardson and Dr. Mark Ghaly, California's health and human services secretary, had few details on how the new system will work or what will happen to giant vaccination sites at places like LA’s Dodger Stadium and Orange County’s Disneyland, which have been inoculating thousands of people a day.
But the change should mean that counties and hospital networks — which have been scheduling appointments and determining eligibility under broad state guidance — will move at a more uniform clip. Residents have been baffled by the varying systems as some counties will vaccinate people 65 and older while others are limited to the more restrictive 75 and up.
Counties say they welcome change if that means more clarity and information, but also warned that local governments are the eyes on the ground that ensures vulnerable populations — including people without insurance or transportation — are inoculated.
“We would see this change moving from a system that was not working, that was piecemeal in structure, to a new system that could work if it is structured carefully and doesn’t risk those populations that we’re most trying to protect," said Graham Knaus, executive director of the California State Association of Counties.
But supervisors and officials at a Santa Clara County Board of Supervisors meeting Tuesday fretted over the idea of a third-party administrator making changes for such a massive state. Dr. Jeff Smith, the county's executive director, said he has been “trying to decipher press releases and announcements and speeches" to figure out what will happen.
Teri Perlstein, who set up the Facebook group VaxMe OC to help frustrated residents navigate Orange County’s vaccine registration site, said more consistency is sorely needed. She said she has been fielding questions from teachers about whether they can drive up to the Los Angeles County city of Long Beach to seek a vaccination sooner than they’ll be able to get one in Orange County.
“I don’t think it’s fair to have it inconsistent depending on what side of the line you live on,” she said.
With the latest announcement, Perlstein said many questions remain about the state’s plan, including whether it will affect residents who got their first shot and are waiting on their second. She also asked what paperwork essential workers would need to present to get a vaccine from the state.
Right now, the biggest issue for residents “is the lack of real communication,” she said.
California has said healthcare, education and childcare, emergency service and food and agriculture workers, as well as anyone 65 and older, are eligible for vaccines. After that, eligibility will be based on age.
The third party administrator or administrators will allocate vaccines directly to providers, which will include county public health systems, pharmacies, health systems, public hospitals, community health centers, pharmacies and pop-up sites.
The state has launched a website called “My Turn” where people can sign up to be notified when they are eligible for a vaccine and to schedule appointments.
Dr. Charles Bailey, medical director for infection prevention at Providence Mission Hospital and Providence St. Joseph Hospital in Orange County, welcomed the change. He said hospitals were equipped to vaccinate their own workers, but that’s on a much smaller scale than what’s required to roll out the vaccine to the general public.
He also said that simplifying the requirements also makes the process easier, and advanced age is the biggest risk factor beyond any other underlying conditions. Allowing the state to seek out an equitable distribution of the vaccine will allow counties to focus on getting as many people as inoculated as possible.
“It will alleviate the counties from having to defend decisions, which obviously they don’t need to spend time doing that,” he said.
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Har reported from San Francisco
