I will write about my own state since I am heavily involved at both the Private and Public Level. As for the public level, here is how our rollout went.
1. The Maine CDC receives and houses all the vaccine.
2. Any entity wishing to be a vaccine administrator has several approval steps involving a lot of paperwork. Pictures, checklists, signatures, license verifications, and so much more.
3. TRAINING! There were mandatory videos and quizzes for all levels of administrator who were to be involved. Top down training from the CDC, the State, and the Manufacturers.
4. Then State EMS is involved in the roll out. Yay, more cooks in kitchen. An office which has 4 full time staff.
5. The State EMS scrambles to ensure everyone knows how to give an IM, also rapidly trying to alter its online EMS reporting system to ensure a report is generated on every patient in order to extract the data required to be reported to Maine and Fed CDC. Website has glitches...other glitches are found AFTER roll out and clinics start.
**Important comment I keep making from the Top Down is this....everyone had a FULL TIME job BEFORE all of this...developing, rolling out and overseeing this IS a new full time job. So either hire new people with skills and experience or privatize it!!
6. State EMS develops a roll out plan which they try to apply equally across the state, in every county which is just stupid. Put out some suggested guidelines and then let each county chase their own success.
7. The slowdown....is because the State EMS and Maine CDC are trying to have each county complete each phase entirely prior to moving to next phase. I will toot my own horn here...I kicked ARSE in my county!! I have been done with Phase 1 for two weeks yet prohibited from moving on because other counties had not. So what is the solution?? The Maine CDC stops sending me vaccine, they withhold it. Even though other counties were sent enough to do their phase 1, I stopped getting shipments. So they are trying to regulate how much vaccine is out there which is plain stupid. If we want herd immunity, let me start with developing it as fast as possible.
8. I am now getting 400 more doses this coming Mon and Tues. I could already have pumped out 1000s.
**As of this past Friday, the State of ME had NOT distributed even HALF of what it has received from CDC.
And regulatory compliance!! I have a 40 page document on how to store and transport the vaccine. 40 pages!!
And while the big pharmacy chains are great, have infrastructure, not every state has one of those on every corner FYI...my state is littered with mom and pop pharmacies. And again, even the little places, even the big places...they all had jobs prior to this. Staffing is an issue...even using off duty EMS staff, staffing is an issue.
**Remember kids...the vaccine is FREE !! The CDC sends you the vaccine and thee supplies to administer it for FREE. We can NOT charge for the vaccine or the supplies. We can bill insurance if available, can NOT collect copays or balance billing. We can NOT turn away anyone without insurance.
So all these costs associated with these services are upfront and out of pocket! Remember that !!! All my labor costs, benefits, equipment (iPads, storage for vaccine, building space) etc...NOT FREE and out of pocket up front in order to give the vaccine. So this hinders a lot of businesses unless you are one of those billion dollar chains or a publicly funded entity.
The staff I use for my public role, I pay time and half rates. I will be able to seek reimbursement at a later date from The Cares Act...however, the government will first see how much I collected from the insurance companies and then subtract that from the OT I sought reimbursement for. And how much will the insurance pay me??? It is between $18-$28 per shot.
Do the math and you will see where additional slow downs are and why.
I am meeting'd out...we have these mandatory Zoom meetings several times a week. WHY!? We sit and discuss BS. Just give me the vaccine and let me push it out. It is becoming so mundane and stupid and painfully obvious none of these people are qualified to be making these types of decisions or plans.
Meanwhile I am fielding phone call after phone call, emails and in person visits of businesses and people needing the vaccine. Yet here I sit on my thumbs.
Anyways..being the solutions guy and the entrepreneur I am...I have done a thing.
I actually have done mass vaccine roll out programs...in Afghanistan. In my former business owner life...I actually imported vaccines to Afghan. My staff administered in excess of 100K+ vaccines all over the country. What we need here in my state is the easiest shlT ever compared to what I did before. Cold chain concerns....really?? I have that nailed. Assembly line, Warp Speed administration...I got it covered.
Anyways, like I said, I know a guy...and he should get his CDC approval number this week and then he will be in it to win it.
