Providing few details, Governor Gavin Newsom announced that Blue Shield of California will take over the state’s struggling distribution of the Covid-19 vaccine. Kaiser Permanente has agreed to serve in a supporting role.

With no contracts available for review, the public is left in the dark with no idea of the cost to taxpayers, changes to the state’s relationship with county health departments, the nature of the provider network, or any related information technology costs. Below is a copy of the letter Senate Republicans sent to the Governor:

February 3, 2021

The Honorable Gavin Newsom
Governor of California
State Capitol
Sacramento, California 95814

Dear Governor Newsom:

California’s COVID vaccine rollout has been chaotic so far and lagging behind other states. We know you agree that our state can and must do better to ensure a quicker and smoother distribution of the vaccine to every community.

While your Administration has provided some information since our January 27, 2021, letter to you regarding your desire to contract with a Third Party Administrator (TPA) to take over COVID vaccine distribution, there remains many unanswered questions. Accordingly, we are requesting your Administration to provide more information in the following areas:

1. The TPA’s ability to interface with existing and under-construction vaccine-related IT systems;
2. Categories of individuals that may be disadvantaged by the transition from your current tier system to a new, age-based methodology; and
3. The relationship between counties and the TPA.

California’s poor track record is well-documented with respect to IT systems in general. You have announced with much fanfare the MyTurn.ca.gov website, yet it currently serves only two large urban counties while ignoring the state’s 56 other counties. We are requesting answers to the following questions:

1. Given the state’s poor IT record, what steps are being taken to ensure that MyTurn will not meet a similar fate?
2. What specifically is being done to ensure that MyTurn seamlessly interfaces with the TPA’s system?
3. Can you confirm that the TPA will use MyTurn?
4. Is the TPA required to use MyTurn, even if it proves a failure?
5. What contingency plans do you have in place should you encounter problems on any of these fronts?

Furthermore, the current vaccine distribution methodology – with its many phases and sub-tiers – is overly complex and confusing. We are concerned the transition to an aged-based prioritization may inadvertently leave behind certain deserving populations. We are requesting your Administration provide answers to the following questions:

1. What becomes of younger people employed in transportation, industrial, commercial, manufacturing, and other sectors deemed essential (currently next in line in Phase 1B Tier 2)?
2. What becomes of individuals – of any age – with developmental disabilities and other underlying health conditions (currently in Phase 1C)?
3. What about people in their 20s, 30s, or 40s involved in other critical industries such as water/wastewater and energy (also in Phase 1C)?

The lethality of COVID is indeed greater among older individuals. However, we believe there must be a balancing act between those most susceptible to the disease and those at greater risk of exposure. We are very concerned that the speed with which some of these decisions have been made, coupled with the lack of transparency, may have resulted in methodology changes that did not give sufficient weight to these questions.

Lastly, we share the concerns expressed by counties and local health officers that the vesting of distribution responsibility with the TPA could result in the role of counties being reduced to solely providers and not partners possessing local expertise and knowledge of their respective communities. What steps are you taking to ensure the TPA will treat counties and local health departments as true partners in vaccine distribution?

We understand you are currently in negotiations with Blue Shield of California (BSC) to become the TPA, with Kaiser Permanente (KP) in a supporting role. We believe it is shortsighted to not involve the Legislature in the negotiation process. While we acknowledge both BSC and KP are respected managed care organizations, we also believe our questions and concerns – in both this and previous related letters – should be fully addressed prior to any TPA contracts being finalized.

We strongly urge you and your Administration to address our concerns. We look forward to your prompt reply.

Sincerely,

Senator Jim Nielsen
Senator Pat Bates
Senator Scott Wilk
Senator Melissa Melendez
Senator Brian Dahle
Senator Rosilicie Ochoa Bogh

CC: Dr. Mark Ghaly, HHS Secretary
Yolanda Richardson, GovOps Secretary