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County nervous over shift to insurer

CORONAVIRUS » Array of officials express skepticism about handing off vaccination management to Blue Shield


As they prepare for nonprofit insurer Blue Shield to take the lead in vaccine distribution in Sonoma County, health officials and local elected leaders were skeptical and concerned Wednesday that this move could be another state-led pandemic setback.

Recalling the COVID-19 vaccine debacle here last month at a Rohnert Park clinic operated by a state vendor, county officials acknowledged they are apprehensive about losing control of the inoculation campaign and plan to keep their network of vaccination clinics in place.

Effective March 7, Blue Shield, which California health officials contracted last month to be the state’s vaccine administrator, plans to use the county’s network of clinics, health centers and other partners for inoculations. But the insurer will procure the weekly vaccine supply and decide how many doses are delivered to individual local vaccination sites. Under its state contract, Blue Shield also will work to ensure shots go into arms in a racially equitable fashion.


“We have a lot of pieces in place, a Plan B in place to ensure that if there’s a breakdown in their system that we’ve got backups, because we’re doing it right now,” said Ken Tasseff, Sonoma County’s vaccine coordinator. “We are not dismantling anything until we are confident (Blue Shield) has it right.”

Blue Shield also will take control of scheduling and tracking the coronavirus vaccine doses in the county. This week, the health insurance giant assumed that role in 10 other California counties, mostly in the Central Valley.

State officials said the action is aimed at getting residents inoculated more efficiently, increasing public transparency about where vaccine doses go and ensuring shots are getting into arms of people in communities disproportionately hurt by COVID-19.

County health officials and supervisors discussed the Blue Shield shot takeover during a press briefing. They hope the move increases the weekly vaccine shipments for the county.

Blue Shield on Wednesday declined to answer several questions from a Press Democrat reporter about the new vaccine distribution plan here. Erika Conner, Blue Shield’s senior spokeswoman, referred the questions to the California Department of Public Health.

Under a state contract for which it will earn no profit, Blue Shield is managing a state vaccine distribution network that this week delivered about 1 million doses to residents. As California surpassed 50,000 coronavirus deaths Wednesday, becoming the first state to reach that sad milestone, the state is counting on Blue Shield to accelerate inoculations.

Dr. Urmila Shende, the county’s vaccine leader, said local public health staff members, who have spent weeks working out kinks in the county’s inoculation rollout, will do everything they can to ensure a smooth transition with Blue Shield. Still, she warned there could be problems.

“We’ve experienced during this whole vaccine rollout process that it’s not easy,” Shende said. “So we’re really going to work hard with the third party administrator (Blue Shield) to make sure that all the things we’ve put into place lead to as successful a rollout as possible.”

Shende believes the county will receive more vaccine doses through Blue Shield, as has been the case with some of the counties participating in the first wave of centralized distribution.

The county still has nowhere near enough doses to meet residents’ demand. Nonetheless, this week the county broadened vaccine eligibility to a group of more than 60,000 residents, including those age 65 and older, plus education, child care, food production, emergency services, grocery and restaurant workers.

The county started in December inoculating health care and nursing home residents and staff, moved to residents 75 and older, then to those 70 to 74 before finally aligning with what the state did in mid-January: start taking shot appointments for seniors 65 and up.

Partnerships with local community health clinics and medical providers has led to a robust network of county vaccination clinics that could inoculate many more people than the 7,680 doses the county received this week, Shende said.

“If we had enough vaccine supply, we would be able to do at least six times that much, if not more,” she said. “So we have built up capacity at this point within the last five to six weeks.”

County Health Officer Dr. Sundari Mase said she’s worried a “one-sizefits- all” approach to vaccine distribution statewide could create problems, particularly in a state with 58 counties of different sizes and diverse demographics.

Supervisor Chris Coursey expressed a lack of confidence in Blue Shield’s online vaccination sign-up system. The county has earlier experience with the peril of the online shot appointment system state vendor Optum-Serve used for a Rohnert Park clinic last month. With the age eligibility incorrect then, the county had to cancel thousands of appointments out of the gate.

Lynda Hopkins, chair of the county supervisors, said she wasn’t happy about the loss of local control over COVID-19 vaccinations, after all of the work that’s gone into ensuring that the most vulnerable county residents get inoculated first.

“We’re going to be shifting from this constellation approach, where we work with trusted community partners who have deep relationships with the communities that they serve to a much more centralized, command-and-control approach that is really designed at getting that vaccine out the door as quickly as possible,” Hopkins said.

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