As the state prepares to end its state of emergency, sites with the least demand will close first.
California is preparing to close dozens of state-run COVID-19 testing and treatment sites before the state of emergency is expected to end in February.
Sites operating below 50% capacity are expected to close by the end of January. Forty-four OptumServe sites will be shut down this week and 48 mobile “mini-buses” will begin shutting down in two weeks, according to the California Department of Public Health. OptumServe, a healthcare operations company, operates 123 testing and treatment sites along with four vaccination clinics through state contracts.
The health care giant has at least four contracts, under its former name Logistics Health, with the state totaling $1.05 billion to provide testing and vaccination services although it has been criticized in the past for its erratic rollout . Another arm of the company has signed an additional $47 million contract to design a data management system for COVID-19 test results.
“A definitive plan for the demobilization of the remaining sites is being prepared, but we have not set a completion date,” an unidentified department spokesman said in a statement. The state health department only responded to emailed questions and did not attribute the statement to a person.
The state of emergency, which has provided extra funding and staffing flexibility at medical facilities, is expected to end on the last day of February.
The closings come just a week after Governor Gavin Newsom released his January budget proposal, which transfers $614 million in unspent COVID-19 response funds to the state’s general fund and slashed the amount of money for the pandemic for next year.
Last year’s budget included $1.8 billion for the state’s COVID-19 emergency response and long-term strategy, while the proposed budget for next fiscal year is only $176.6 million. The cuts come as the state faces a projected deficit of $22.5 billion, under Newsom’s proposal. State Secretary of Health and Human Services Dr. Mark Ghaly said in a budget call with reporters that most of the proposed reduction comes from lower state testing responsibilities, but stressed that the spending reductions are not “a statement on California’s transition from COVID.”
“We will continue to look for opportunities to support public health,” Ghaly said. “We’ve learned a lot through this COVID response and need to make sure we don’t miss out on those gains.”
Demand for COVID-19 molecular testing has plummeted statewide since last January when the omicron variant pushed hospitals to the brink of collapse. At the time, more than 800,000 PCR test results were reported in a single day, and more than 15,000 people were hospitalized with COVID-19 at the height of the surge. By comparison, fewer than 30,000 test results and 4,600 hospitalizations were reported on the last day of December (the most recent day with final tallies, according to state data).
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Statewide, county health departments are preparing for the closures and absorbing the costs into their budgets.
In Los Angeles County, OptumServe will stop operating four sites, but the county will contract with another vendor to keep the doors open, a spokesperson for county health services said by email.
“Importantly, the change will happen seamlessly,” the Health Services Communications Office told CalMatters in an unsigned statement. “Community residents looking for a test site will experience no disruption to existing services.”
During a media briefing last week, Los Angeles County Public Health Director Barbara Ferrer said the county was committed to ensuring there are “extensive” testing and vaccination options.
In other areas of the state, health departments are unable to manage sites on their own. All five OptumServe sites in Fresno County will close by January 31. Only one of the sites is currently operating above 50 percent capacity, public health spokeswoman Michelle Rivera said. The test-to-treat mobile buses will stop operating the first week of February.
Community members will still have options, Rivera said. The County Health Department continues to work with local organizations, UCSF-Fresno and the Fresno State School of Nursing to continue offering testing, treatment and vaccination services throughout the area. The Fresno County Board of Supervisors also approved funding for a rural mobile health program to provide health care to farm workers and other rural communities.
Fresno County was hit especially hard by the latest post-holiday surge of COVID-19, as well as concurrent waves of influenza and respiratory syncytial virus, issuing emergency no-transport orders to EMTs for the sixth time since inception of the pandemic to fight the overflowing emergency departments. Do-not-transport orders, also known as evaluation and referral, require ambulance personnel to determine whether a patient requires emergency transport or is stable enough to be referred to a non-emergency medical facility such as primary care.
In Santa Clara County, state-run sites are also expected to close in the coming weeks, Emergency Operations spokesman Roger Ross said. The county, however, will continue to operate three mass vaccination sites and has already begun to build the COVID-19 response into normal health department operations.
“Public Health recently created a COVID prevention and control program as part of our standard operations. Most of the work now resides here,” Ross said. “Unfortunately, it looks like we will be dealing with COVID for the longer term.”
In Orange County, where COVID-19 health orders have at times drawn public ire, testing and vaccination strategies will largely shift to the “open market where people will self-manage COVID-19” through health care primary care and other community resources, the health department announced in a news release last month. County-run vaccination sites, which served about 200 patients a week, were closed in December, although the health department continues to offer vaccinations for vulnerable populations such as homeless people, said Obinna Oleribe, deputy chief of services Orange County Public Health Service.
The federal government requires health insurance plans to cover eight over-the-counter COVID-19 tests per person per month, including FDA-approved home PCR tests. Each family can also order four free rapid tests from the federal government. When used appropriately, home tests of all types are considered highly accurate, although data shows that PCR tests are more reliable.