As Missouri’s COVID-19 vaccine rollout geared up, the state left the work of making sure Black and Latino communities got equitable access to nine regional groups.
The theory was simple — a regional organization would know its area best and would understand how to reach at-risk community members.
But more than a month into the rollout, four of those regional teams aren’t up and running and just 5% of the doses have gone to Black Missourians.
In the state, Kansas City has the highest number of vaccine deserts in areas that are particularly medically vulnerable, according to an analysis by Deloitte. When Kansas City’s implementation team gets started — and it still has not, even this far into the vaccine rollout — it will span 13 counties and cover more than a million people.
Kansas City Councilwoman Melissa Robinson said that’s “appalling” and “unbelievable” that the regional team is just now getting off the ground.
“It’s a life and death situation,” said Robinson, who is also president of the Black Health Care Coalition. “The vaccine is the difference between someone becoming ill with the virus and dying or living.”
Regional officials chalk up the problems to a lack of state funding and confusion about the state’s vague expectations, but now wonder if they should have stepped forward sooner.
“I don’t think there’s any question that this has delayed some of the potential coordination and response in the metro area,” said Dr. Rex Archer, the Kansas City Health Department director.
Parson touts vaccine plan
Missouri was one of the first states to submit a plan for vaccine distribution to the federal government, something Gov. Mike Parson touts. The more than 100-page document spells out a structure for implementing the rollout, dividing the state into nine regions and relying on a “regionally empowered model.”
With the coronavirus disproportionality killing Black and Latino residents, it was critical to ensure those communities got access to the vaccine. But the state left creating a proposal “to assure equity is achieved” up to regional teams.
It’s not the only thing the regional groups are tasked with. The responsibilities range from making sure vaccine providers have the right type of storage for doses, to implementing a plan to reach “communities of color,” and helping administer the vaccine on site.
The laundry list of responsibilities also includes working with 14 different types of institutions to assess vaccination needs — everything from schools to food manufacturing plants, hospitals and grocery stores.
‘You get what you pay for’
The nine regional teams would get no more than $128,479.88 from the state to do this. That’s “obviously” not enough money, Archer said.
“You get what you pay for,” Archer said. “And sometimes you don’t get what you don’t pay for.”
The state originally wanted applications for the regional implementation team due in mid-November. But when the state extended the deadline to December, there were still no organizations that applied to head up the effort in the Kansas City area.
Both the Truman Medical Centers and the Mid-America Regional Council expressed interest, according to Missouri Department of Health and Senior Services spokeswoman Lisa Cox.
But MARC, an association of city and county governments that spans the metro Kansas City region, didn’t end up applying. The state’s expectations were unclear and without a “more fully developed” state plan,” it was unclear how MARC would assess planning work, according to a December letter sent to the state and obtained by KCUR.
“In retrospect, we here in the Kansas City area … might have put our foot forward recognizing that there were a lot of unknowns,” MARC community development director Marlene Nagel told KCUR. “But we expected kind of more of a response and dialogue with the state.”
The state has now signed contracts for five of the nine regional teams, according to the Missouri Department of Health and Senior Services procurement manager. Most of those contracts were awarded in late December. Three additional contracts are pending. And the Kansas City regional implementation team will be overseen by Truman Medical Centers and the Jackson County Health Department, according to Cox.
“After not receiving any bids, the State solicited the help of TMC due to the historical partnership and due to it being simpler to work with fellow government agencies contractually,” Cox said in an email.
Cox did not answer questions about whether the lack of a regional implementation team affected the vaccine rollout effort.
The contract is still in the process of being finalized and it’s unclear when the team will start.
A spokeswoman for the Truman Medical Centers/University Health said the safety-net provider has the experience to help coordinate the rollout.
“We feel as though the leadership we have provided throughout COVID, from testing to treatment to the first stages of providing vaccines for the community, along with our ability to build on strong existing partnerships would benefit those throughout the region,” Leslie Carto said in a statement.