On Jan. 27, San Benito County Public Health Services confirmed its investigation into the San Benito Health Foundation (SBHF) for allegedly failing to follow California’s COVID-19 vaccination plan, which outlines the phases and tiers for inoculation. The health foundation responded with a public letter. As of Feb. 9, the investigation is still ongoing, according to County Public Information Officer David Westrick.
News of possible unauthorized vaccinations led to the creation of a petition demanding the firing of Rosa Vivian Fernandez, CEO and director of the health foundation.
SBHF, located at 351 Felice Drive in Hollister is a 501(c)(3) nonprofit organization and federally qualified health care center (FQHC) that has provided care for those who lack health care services since 1975. In 2020, the health foundation served 7,424 clients. Last April, Congressman Jimmy Panetta announced the release of $4.5 million for COVID-19 relief to California community health centers. SBHF received $699,095.
Fernandez responded to BenitoLink via email* about her decision to vaccinate individuals outside of Phase 1A, which includes health care workers and long-term care residents. (CORRECTION: Sentence originally said Fernandez spoke to BenitoLink about her decision…)
The following Q&A was not edited by BenitoLink and is published exactly as it was presented.
BENITOLINK: As both a Rotary member and the CEO of SB Health Foundation, why isn’t this a conflict of interest when you allowed club members to be vaccinated?
FERNANDEZ: To be clear, Rotarian members did not approach SBHF requesting vaccines. Some Rotarians were likely vaccinated because they qualified for vaccinations under the then-current tiers in effect. The fact that I am a Rotarian as well is immaterial. As you probably know, the Rotarian club members include a considerable number of individuals who volunteer their time and service to community organizations, including SBHF and other health care and emergency providers. That is at the heart of that club’s mission. Many individuals in the San Juan Bautista Rotary Club serve as volunteers for our clinic, and some—well before the pandemic—were part of the list of SBHF staff and volunteers for whom we received vaccines specifically designated for this group of individuals as a federally qualified health center (FQHC). As large-scale vaccination efforts truly begin to kick off in the coming months, we will need all of these many qualified, reliable volunteers to meet the challenge of holding ongoing vaccination events.
Did you receive any vaccine allocations from the federal government?
No. We received an allocation of 100 vaccines for our FQHC in the first week of January. As the vaccine production and distribution efforts ramp up under President Biden’s COVID-19 plans, we expect that we will begin to receive far more vaccines directly from federal and state government sources, rather than through the conduit of the county.
If you only received vaccine allocations from San Benito County, why did you feel you could vaccinate individuals beyond what was allowed under Phase 1A?
This is a good question because I believe it reflects a lot of the current misunderstanding with the San Benito County Public Health Department and the public’s understanding of the vaccination distribution. Our actions are based on guidelines provided directly from the California Department of Public Health, based on guidance from the Centers for Disease Control (CDC). The CDC recognized the need for cooperative relationships between healthcare providers and volunteer communities. The CDC’s Phase 1A guidelines state that a COVID-19 vaccine is authorized for, “paid and unpaid persons serving in health care settings who have the potential for direct or indirect exposure to patients or infectious materials.”
SBHF has a lot of volunteers who qualify under this directive. Moreover, once vaccines have been “defrosted” for use, they must be used within a short time period. Unfortunately, many individuals who have vaccine appointments do not end up showing up and the CDPH guidelines are clear that in such cases, vaccines should not be wasted and providers are directed to attempt to find individuals who are immediately available for a vaccine, which may include those in the next lower tiers.
The guidelines are continually changing and there is a definitive push from the president and the governor to expedite the process of moving through the tiers to get vaccines to those in high risk populations where COVID-19 infections are prevalent. One immediate step in this effort is to have Blue Shield direct the distribution of vaccines, rather than solely relying on county health departments.
The president’s plan recognizes the vital role community health centers will play in the forthcoming efforts to engage in widespread, large-scale vaccination efforts given their ubiquitous role in serving medically underserved populations which are particularly hard-hit by COVID infections, and our broad experience and expertise in administering all manner of vaccines.
Why did you not notify SBC Public Health Services that you had excess doses of COVID-19 vaccine?
Each vaccination administered by a local provider is entered into the California statewide database—as prescribed by law—and emphasized during the mandated vaccination training. This information was and is always available to the San Benito County Public Health Department in real time. We also provided daily and weekly reports of vaccine numbers in which they can track and monitor any information they seek, at any time.
According to Supervisor Mark Medina, you asked him to leave your office after he began to inquire about why you vaccinated individuals outside of Phase 1A. How would you describe what happened?
Supervisor Medina was asked to leave my office after he entered the premises unannounced and continually acted in a hostile and belligerent manner, causing myself and the other women in my office to feel extremely uncomfortable. The final act that forced our hand was his failure to abide by our social distancing guidelines when he stood behind my chair and lurched over me in an attempt to view private, patient information. At that point, we had had enough of his theatrics, stating that his behavior made us uncomfortable and demanding he leave, and he did. Supervisor Medina did not visit my office to discuss important pandemic-related business. Rather, he simply came in to humiliate and publicly shame me in front of my staff. Had he visited my office with an appointment and requested clarification on vaccination procedures in a professional manner, we would not be at this juncture today. Civility and respect matter. As the chief executive officer and director of the San Benito Health Foundation for over 16 years, I know our clientele, the community, and our business partners. If this matter happened to anyone else in the community, it would not be tolerated. Where is the professional courtesy and respect?
How do you feel about the health department preventing the foundation from giving more COVID vaccinations? Do you think that will change soon?
We are working with the county to alleviate their concerns and improve the vaccine allocation and distribution process. The allocation process itself is irregular at this point because of the extremely limited supply. We have never had any real sense of how many vaccines we might get any given week and even before the county announced its investigation, they had allocated no vaccines to SBHF. We are only at the very outset of the COVID immunization process. The heavy lifting is yet to come and all community resources, including the county, SBHF and every other health care provider and volunteer group will be desperately needed to succeed. It is likely all of our roles may change as this goes on but we need to be on the same page and have positive, professional and clear communication channels going both ways. Whether the county does or does not provide SBHF vaccines is really of much less importance than the real issue, which is making sure the county makes all necessary efforts to get vaccines to the individuals and populations served by SBHF. We stand ready to do our part, to the best of our ability and control what we can control.
A petition is circulating demanding you resign over this incident. How do you respond? Do you feel that you’ve done anything wrong?
I am not aware of a petition and am far too busy overseeing this health center to worry about social media or let it dictate how we operate. I love this organization and our community and my past experiences have taught me that you need to have tough skin and a clear focus to make the necessary difference in the community that SBHF strives for. This has never been truer as SBHF has strived to continue operating and making a difference in this public health emergency of all emergencies. Tackling the issues during this time has truly been a matter of life and death for so many in our community. I remind everyone that SBHF has been tirelessly providing services, and otherwise continuing to provide care for the most vulnerable during this health pandemic. The Latinx population in San Benito County are some of the hardest working folk. These people are in the service industry, watching our children, cleaning our homes, packing our groceries, working construction to build homes, working stores around the valley and providing some of the very food we eat and serve to our families daily. They are also the members of our staff, who represent the community in which we serve. It is with great pride that we look forward to serving these worthy individuals as we all move ahead to the next phase of achieving widespread vaccination.
How many patients/clients does the health foundation serve?
2019-20, we served 7,424 clients. Operating full-time since 1975, we provide health care, dental care and vision care to our residents and community at large. Studies have shown that communities with better access to primary care such as SBHF provides are healthier and more productive communities.
How many COVID-19 vaccines has San Benito Health Foundation distributed?
We distributed 789 vaccinations in a three-week period. We can do more. Our clinic can successfully manage between 600 and 800 vaccinations per week. Every day that goes by and we are not vaccinating members of the community, people are dying. With the arrival of new variants of the virus, the smartest public health authorities in the nation have strongly urged all involved in the vaccination process to get the vaccines into as many arms as soon as possible.
Given the current investigation, do you think SB Health Foundation should be able to continue vaccinating individuals?
Unreservedly yes. We remain in a never-before-seen public health emergency and crisis. In light of the coronavirus mutations, every level of government has determined that we are in a race against time to vaccinate as many individuals in as short a time as possible. We are really only at the very tip of the vaccination effort. I am positive we will be providing innumerable vaccines over the next half-year. The only question is will it be with and in cooperation with the county or not. We hope it is the former. The only way we can defeat the pandemic in San Benito County is by working together and administering vaccines as quickly as possible.
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