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INDUSTRY NEWS: Getting To The Point: Insights from New York’s Recent COVID-19 Vaccine Experience

Author: UCA Admin/Tuesday, December 29, 2020/Categories: Industry News

Over the holiday weekend, vaccine distribution in New York took a dramatic turn that involved the Northeast Regional Urgent Care Association (NERUCA) and UCA engaging in a rapid-fire negotiation. This was the culmination of intensive advocacy efforts that took place over the preceding two weeks, aimed at reprioritizing the state’s urgent care centers from Tier 1B to Tier 1A, in an association-driven effort to provide vaccine to urgent care workers. It is estimated that the difference between the tier designations could translate to as much as 4-5 months in terms of time to vaccine access.   

We share this experience in order to improve everyone’s understanding of the dynamics we all face looking to improve access to CV-19 vaccine for all urgent care workers. 

Takeaways:

  • Regional vaccine distribution plans remain fluid and can definitely still be influenced. Urgent care owners/operators/clinicians can influence that process by aggressively and broadly identifying any relevant agencies and individuals that shape the decisions as to who gets vaccinated when. NERUCA was successful by directly and repeatedly making a legitimate case to local health commissioners, state legislators, the state medical society, the state department of health, regional Point of Distribution (POD) officials, and hospital administrators. The strategy gelled when UCA was looped in at the point when discussions with state officials overseeing distribution got significant traction.  

  • The process for obtaining staff vaccination began with practices that signed up as community vaccination points. If you did not sign up to vaccinate the public, you were going to be excluded from any vaccine access at all, which was the original impetus for NERUCA advocating to obtain vaccine for members that fell into the latter group. 

  • The turnaround on final participation decision-making may be short.  New York urgent care practices had less than 1 business day to commit to join in. 

The full story so far. 

Sometime in late November:

The political winds began to blow, and though public health departments were queued and prepared to be the primary outlet to receive and distribute vaccine, hospitals moved to the forefront and were designated as first to receive vaccine.

Mid-December

Hospital systems had positioned themselves to become the locus of public vaccination planning in concert with local public health authorities, and the regional POD program was introduced. It was around that time it became known to NERUCA Government Affairs Committee (GAC) members that urgent care workers were not designated as Tier 1A for vaccination, at which point NERUCA GAC swung into action. Late last week NYS-DOH agreed to set aside 10,100 initial doses of vaccine for urgent care workers. 

Based on a consultant-derived formula, NYS-DOH Bureau of Immunization selected 101 urgent care locations statewide, exclusive of New York City (New York City based urgent care is being overseen by a separate authority), designated to get 100 initial doses each.  

Saturday, December 26th

The Bureau contacted NERUCA and UCA by email to verify that all 101 chosen locations were genuine urgent care centers, in preparation for submitting the list of locations to the CDC for vaccine shipment. The Bureau’s plan provided guidance that once an urgent care center’s staff was vaccinated, the center could more broadly open up vaccination to other Tier 1A eligibles. NERUCA GAC rapidly assembled a joint UCA-NERUCA task group to analyze and respond to the initiatives being brought forth. 

Sunday, December 27th

Task Group members were able to speak directly with the Bureau Director and propose an additional vaccine rollout option, whereby the urgent care community could share resources across centers to provide vaccine to staff not part of the 101 selected centers, prior to opening up those sites to public vaccination. This plan is currently under review by NYS-DOH.

The Bureau notified the 101 designated urgent care practices of the impending vaccine shipment. Included within that notice was a Memorandum of Understanding (MOU) relative to receipt of vaccine, as well as follow-on reporting, and other requirements. The MOU was due back to the Bureau by the following day (Monday) at noon. 

Monday, December 28th - 8am

The NERUCA-UCA Task Group met to discuss potential logistics of a vaccine sharing/transfer program for New York centers and prepped to present same to the Bureau. 

Monday, December 28th - 12pm

Governor Andrew Cuomo’s office announced that urgent care workers had been upgraded from Tier 1B to Tier 1A, and were eligible to receive COVID-19 vaccination this week. 

“After months of advocacy and awareness initiatives the NERUCA GAC was really pleased to see the Governor recognize the value that urgent care played in supporting primary care physicians and hospital Emergency rooms during the onset of COVID-19.  We commend the Governor for acknowledging that prompt convenient care was available to our communities throughout the pandemic by including us in Level 1a.”   

- Todd Martin, MBA, FACHE, Executive Vice President and Chief Operating Officer, Emergency One and President, Northeast Regional Urgent Care Association 

Recent experiences in other states:

Arizona: A member who was having difficulty getting vaccinated kept calling public health and getting put on hold with no pickup.  One day she stayed on hold until someone answered (over an hour) and was told that the website wasn’t working but she could get registered over the phone and go to a drive-up site in Maricopa county (not her home county) to get vaccinated.  There was no line and the vaccinators indicated the turnout had been much less than anticipated and they had so much extra vaccine they were going to open up Phase 1B early. 

Florida: Outreach to get registered as a potential vaccinator started today via fax to private provider offices (including urgent care).   

Alabama: Some non-system affiliated urgent care teams have been vaccinated through their local health system’s vaccine supply. 

New Jersey: One practice was successful in obtaining vaccine for their team by volunteering to be the central location to vaccinate the town's EMS workers.

Here’s the Point:  Every state is different, and sometimes differences exist county-to-county within states.  Engaging in outreach at any and all levels until you have the answer(s) you need is critical during a time like this. 

Share your COVID-19 vaccine experiences here.

Thanks for all that you are doing during this pandemic.

Lou Ellen Horwitz, UCA Chief Executive Officer

Special thanks to Dr. Jonathan Halpert for his assistance with this article.

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