Hospitals look for state guidance on vaccinations

by | Dec 30, 2020

TALLAHASSEE — Gov. Ron DeSantis’ administration is relying on Florida hospitals to provide COVID-19 vaccinations to health care workers, seniors and at-risk populations in the communities the hospitals serve.

It’s a task that some hospitals fear could be impossible given the state’s large senior population.

In a Tuesday phone call that included hospital officials and the secretaries of two state health-care agencies, HCA West Florida Division Chief Medical Officer Larry Feinman said it would take the HCA hospitals in PInellas County months to vaccinate residents who are 65 and older against the virus that causes COVID-19. DeSantis issued an executive order last week that called for people 65 and older to be near the front of the line.

“And, of course, we cover far more than just Pinellas County,” Feinman said on the call. “Has the state come up with a plan for what the state is going to do? Or are we leaving this entirely to hospitals to vaccinate 65 and older?”

Department of Health Secretary Scott Rivkees told Feinman that the state will have “multiple approaches” to getting the vaccine out to the 65-plus population and said county health departments and other “community partners” will play a role in getting the job done.

Rivkees, who also serves as Florida’s surgeon general, did not elaborate on the community partners working with the state. The DeSantis administration has not made available to the public a COVID-19 vaccine distribution plan it was required to submit to the federal government.

But DeSantis has made clear in public appearances that he is relying on Florida’s hospitals to take a lead role in helping get the vaccines out to the public. More than 170 hospitals across the state had received either Moderna or Pfizer vaccine doses as of last week.

DeSantis’ office announced Tuesday night that 127,100 doses of the Moderna vaccine are expected to arrive in Florida this week. Most of those doses, 93,900, will be distributed to county health departments that have not previously received doses. The remaining 33,200 doses of the Moderna vaccine will be sent to 54 hospitals that have not received doses.

Another 118,950 doses of the Pfizer vaccine will be sent to the so-called Pfizer 5 hospitals: UF Health Jacksonville, Tampa General Hospital, AdventHealth Orlando, Memorial Healthcare System in Broward County and Jackson Health System in Miami-Dade County. Those five hospital systems, as well as 25 hospitals they agreed to work with, will be able to administer second doses of the Pfizer vaccine.

The Pfizer vaccine also will be provided to residents and staff members at long-term care facilities in Broward and Pinellas counties who received their first doses of the vaccine through Florida Department of Health and Florida National Guard “strike teams.”

The state is surveying the hospitals that had received doses as of last week to gauge what acting Agency for Health Care Administration Secretary Shevaun L. Harris on Tuesday called their “capacity.” Among other things the survey asks hospitals how many vaccination doses they can administer daily and weekly.

“This is just for planning purposes and to help us get a sense of how many individuals, how many belly buttons you can vaccinate in a particular day or in  a particular week,” Harris said on the phone call. “And actually it’s not belly buttons, I know it’s arms. We’re just really trying to get a head count for your capacity.”

The U.S. Census projects that more than 4.46 million people are age 65 and older in Florida.

DeSantis issued the executive order on Dec. 23 that put people age 65 and older on the priority list for vaccinations and directed Florida hospitals to administer shots.

In targeting people 65 and older, DeSantis is making vaccines available to a population that a federal Centers for Disease Control and Prevention advisory group did not recommend should initially be made a priority.

Other populations included in DeSantis’s executive order include health care personnel with direct patient care and contact and long-term care facility residents and staff.

While long-term care residents and staff and many health-care workers were eligible for the shots before DeSantis’s executive order, the governor broadened the health care providers who qualified.

Initially the state was vaccinating front-line health personnel who the governor described as the “tip of the spear.” But the executive order broadened that to health care providers with direct patient contact.

The executive order also allows hospitals — which have received the majority of the vaccine doses — to vaccinate people they “deem to be extremely vulnerable.”

“The message today is vaccinate,” Rivkees said, adding “future allocations will be based upon the amount of vaccine you are using.”

Through Monday, 146,160 people had been vaccinated, according to state data posted Tuesday. Women had received 87,573, or about 60 percent, of the shots.

Hospital representatives on Tuesday’s call had many questions about DeSantis’ executive order and how it would be implemented.

A hospital executive from Wellington Regional Medical Center asked whether the state would provide facilities with a list of health care providers who would qualify.

“Wellington is in a very large horse area, and we have vets stating they are part of the medical community, so we really need a definition if that would be at all possible,” said the executive, who did not identify herself.

Rivkees said only providers with direct patient contact qualify for the vaccines.

“By patient,” Rivkees said, “we are referring to humans.”

The Wellington executive also asked whether hospitals would need orders from physicians before vaccinating people.

“Vaccines don’t necessarily require a physician’s order,” Rivkees said.

But the state didn’t have answers to all the questions the hospitals asked.

Jim Schmidt with Johns Hopkins All Children’s Hospital in St. Petersburg asked whether the facility, which is licensed to provide care to pediatric patients, could administer COVID-19 shots to 65-year-old adults.

“We certainly want to do our burden in caring for the broader community. But our medical staff is not particularly comfortable administering vaccines to the elderly in a children’s facility with resources that are targeted toward children,” Schmidt said, asking if the agency had any recommendations.

Harris didn’t answer the question but said the state will provide additional guidelines on that issue in the coming days.

1 Comment

  1. John

    This is a typical lack of leadership from trump and DeSantis. They hide and misrepresent Covid-19 information and now they have no plan for vaccine distribution. Where is the National Guard? Is CVS and Walgreens in the distribution plan? What is DeSantis’ plan? DeSantis has had months to work on this, and is too involved with trump’s fantasy of overthrowing our election to care. Florida needs a plan to get the vaccine in the arms of its citizens.

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