Other Sonoma County vaccination sites trying to avoid OptumServe ‘debacle’

Acknowledging the “debacle” that forced the cancellation of thousands of coronavirus immunizations last week, Sonoma County officials vowed Wednesday to take greater control over distribution of the vaccine while noting there is little chance of fixing a flaw in the online portal that allows people to sign up for shots before their turn.

The screening process on the OptumServe website — which relies on a “stupid, inadequate question,” Sonoma County Supervisor Lynda Hopkins said — still fails to stop people younger than 75 from booking appointments more than a week after the county asked the company to improve the site.

The problem at the OptumServe clinic at the Rohnert Park Community Center is now in danger of being repeated at other vaccination sites in the county. A similar glitch is already causing a scramble at clinics managed by West County Health Centers and Sonoma Valley Health Partners, both of which have been working to cancel appointments for those younger than 75.

The county hopes to expand vaccinations next week for members of the general public older than 70 and offer doses to everyone older than 65 within three weeks, vaccine chief Dr. Urmila Shende said Wednesday during a meeting with The Press Democrat editorial board.

But a disjointed and inefficient health care system that has left no one entity fully in charge of local distribution has slowed the campaign to vaccinate the county’s half-million residents and left many confused about where to turn for help.

“It feels like every single layer of government during this pandemic has simply delegated authority,” said Hopkins, chairwoman of the county Board of Supervisors. “The feds said, ‘Hey, states, it’s on you.’ The states said, ‘Hey counties, it’s on you.’ And then we’re supposed be excited to get these crumbs from the state, the most recent crumb being this OptumServe system, which is a state contract.”

It would be much easier to hold the private company accountable, Hopkins said, if the county had entered into the contract directly, rather than inheriting an agreement negotiated by the California Department of Public Health.

The anxiety resulting from the canceled appointments in Rohnert Park underscores the scarcity of vaccine at every level of society. Sonoma County directly received 7,425 doses this week, a small fraction of what will be needed to provide two doses each to the roughly 375,000 adults living in the county.

To address the scarcity, the county has targeted residents 75 and older for the first vaccinations outside of health care workers and emergency personnel. Because many of those seniors have health care coverage through established providers, the county’s Adult and Aging division and its health equity manager worked with a number of nonprofit and medical groups to identify seniors for the OptumServe site.

The Rohnert Park clinic was never meant for everybody, but rather dedicated to those who, in the words of Shende, “had disabilities, who also had less access to technology, and also did not have medical homes, and are from underrepresented parts of our population.”

But that criteria was not mentioned in a Jan. 25 news release from the county announcing the creation of the clinic, nor was it noted on the OptumServe website used to schedule appointments. Problems arose when people began sharing a link to the OptumServe appointment site on social media. More than 9,000 appointments eventually were made by residents younger than 75, and the system crashed. OptumServe wound up purging its entire slate of appointments, mystifying and alarming those who had signed up, before gradually beginning to restore slots for those who were eligible.

“We want to own the fact that the OptumServe situation was a debacle, in terms of access and resources,” said Barbie Robinson, the county’s director of health services.

No doses of the precious vaccine went to waste in the chaos, said Ken Tasseff, the county’s vaccine site coordinator.

OptumServe subsequently amended its website at the behest of the county, noting that you must be 75 or older to make an appointment. But the type is small, and 60-somethings who miss it aren’t red-flagged during the sign-in process, even when they enter a date of birth that should exclude them. Hopkins said Tasseff has made constant requests to OptumServe about the site.

“And the best we’ve got is that stupid, inadequate question asking you to state whether you’re 75 and older,” she said. “And you can still put in your birth date, and still get an appointment.”

Newsom and his Health and Human Services Secretary, Mark Ghaly, have announced a statewide portal, MyTurn.ca.gov, that they say will simplify the process. It’s currently accepting appointments only in Los Angeles and San Diego counties.

Significantly, MyTurn has an entry box for age group, and immediately halts the appointment process if your tier isn’t currently eligible.

That is rarely the case in the patchwork of appointment systems being used by the county-affiliated clinics in Sonoma County. All of them state somewhere that the slots are meant for the 75 and older group. But if you misinterpret that piece of information, there is no additional gatekeeping before you secure a date and time.

West County Health Centers identified that problem on its platform immediately when it began to set up vaccination clinics at Guerneville School and Analy High School this week. The group is using a platform designed by the state Department of Public Health.

Sensing a brewing mess, CEO Jason Cunningham and his staff used their own algorithm to check on the eligibility of those had signed up for the clinics. They found that of the 250 people who had signed up for the first day of shots, close to 80 were ineligible. The health group called every single one of them and explained the situation, expending many hours of labor in the process.

Cunningham worries about the ramifications of the stilted process.

“Relationship is our primary product in health care,” he said. “Particularly in primary care. If we lose the trust of our community, we undermine the trust of health care.”

Sonoma Valley Health Partners, which includes the hospital of a similar name, faced a similar dilemma when it began accepting appointments for a clinic this weekend at Sonoma Valley High School. People younger than 75 reported signing up without realizing they weren’t supposed to. The two-day clinic filled entirely in 24 hours.

By Wednesday, those who were ineligible were getting their times canceled.

“Unfortunately we will not be able to vaccinate anyone who does not meet the eligibility criteria set for our first Sonoma Valley Community Drive-Through Clinic,” a hospital representative said in a statement. “We ask that people not plan to ‘walk-in’ or ‘drive-up’ without an appointment. Supplies and vaccines are very limited.”

The solutions are much trickier when a massive corporate partner is involved. Appointments for two upcoming Safeway clinics, at Grace Pavilion at the fairgrounds in Santa Rosa and at Oakmont Village, were full Wednesday. But it looked like the same quirks existed in Safeway’s online portal. Oakmont residents younger than 75 reported having slots canceled.

Next up could be CVS, which plans to open a clinic at its pharmacy location in Sonoma on Feb. 11.

“We are administering COVID-19 vaccines to eligible individuals based on state criteria,” a representative said when asked what the appointment system would look like. “As part of the scheduling process on CVS.com, patients are asked to attest that all information provided during appointment set up is truthful and accurate.”

As the county prepare to inoculate a much larger population, the urgency of the appointment process is obvious.

“This is the time we need to work out the kinks,” county Supervisor David Rabbitt said. “Soon we’ll be doing thousands a day.”

You can reach Staff Writer Phil Barber at 707-521-5263 or phil.barber@pressdemocrat.com. On Twitter @Skinny_Post.