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From YouTube: Community Vaccine Advisory Committee Meeting #9
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B
Wonderful,
so
I
want
to
welcome
everyone
once
again
to
another
meeting
of
the
community
vaccine
advisory
committee.
I'm
dr
nadine
burke,
harris
california,
surgeon,
general
and
co-chair
of
the
cvac.
As
you
know,
along
with
dr
erica
pond,
our
state
epidemiologist,
and
to
start
off
this
meeting,
we
will
start
with
a
with
an
update
of
our
our
meeting
process
as
we
move
into
now
meeting
nine
of
this
process,
and
I
really
want
to
start
by
thanking
all
of
you
for
being
here.
C
B
D
B
Put
a
lot
of
time
and
commitment
into
this
process
and
we're
really
grateful
for
you
to
be
here.
We've
got
lots
to
cover
today,
so
we'll
move
right
into
our
meeting
process
so
bobby.
Do
you
want
to
take
that
away.
A
Yes,
I
will
thank
you.
I
do
need
to
make
an
announcement
to
the
telephone
operator
if
you
could
put
our
line
back
in
the
communications
room,
so
we
don't
hear
double
I'd,
appreciate
it
and
welcome
again
everyone
just
to
review
the
meeting
process
for
everyone.
As
everyone
knows,
we
appreciate
that
the
members
of
the
community
vaccine
advisory
committee
will
keep
their
cameras
on
so
we
can
look
at
each
other
and,
as
I
like
to
say,
pretend
we're
in
a
room
altogether
somewhere
in
sacramento.
A
I
think
everyone
by
now
knows
how
to
use
the
hand
raise
icon
in
the
participant
section
and
when
you're
ready
to
make
comments
or
ask
questions.
Please
do
use
that
we
have
our
two
asl
interpreters
with
us
again
today:
katie
sales
and
vicki
kennedy,
and
we
also
have
closed
captioning
for
our
members
and
members
of
the
public.
Members
of
the
public
are
listening
on
a
telephone
listen
only
line
both
in
english
and
in
spanish
and
also
through
our
live
streamed.
Youtube
channel
public
comments
are
always
welcome
at
the
covid19
vaccine.
Outreach
at
cdphd.
A
B
A
So
I
just
wanted
to
take
a
few
minutes
to
summarize
the
public
comment
that
we've
received
since
january
19th,
just
as
a
reminder
to
the
community
advisory
committee
members
and
the
public.
A
A
We
receive
269,
individual
or
organizational
submissions
of
public
comment
during
the
period
from
january
19th.
To
february
1st,
I
will
summarize
the
highlights
of
those
comments
quickly.
The
uc
berkeley
school
of
public
health
offered
a
comment
that
we
should
use
an
anti-racist
approach
to
vaccination
distribution.
A
We
had
11
individuals
comment
that
the
process
of
getting
a
vaccine
needs
to
be
simplified.
They
can't
figure
out
how
to
get
a
vaccine,
there's
no
public
announcements
of
where
to
go
to
get
vaccines.
We
had
two
individuals
comment
that
the
accessibility
of
vaccine
facilities
needs
to
be
improved.
There
needs
to
be
parking
and
vaccine
locations
need
to
be
well
signaged
and
posted.
A
A
We
had
many
comments
from
people
with
disabilities
who
are
under
65
wanting
to
be
prioritized
higher
32
comments,
54
comments
from
people
with
underlying
medical
conditions
who
are
under
the
age
of
65,
who
believe
their
conditions,
such
as
diabetes,
cancer,
hiv
and
aids,
hepatitis,
autoimmune
conditions,
lung
disease,
chronic
kidney
disease
and
blood
diseases
should
be
prioritized
higher.
We
had
24
individuals
asking
that
adults
with
intellectual
and
developmental
disabilities
be
prioritized
higher.
B
Thank
you
very
much
bobby,
and
you
know
we
are
very,
very
grateful
to
the
members
of
this
committee
and
also
the
members
of
the
public
for
sharing.
All
of
your.
Your
comments
concerns
your
advice
for
the
data
that
you
share,
as
you
heard
from
bobby.
This
is
this
is
reviewed
and
we
work
very
hard
to
incorporate
as
many
as
possible
of
the
the
concerns
and
the
issues
that
are
raised
into
our
work
processes
and
into
what
we
take
forward.
B
I
wanted
to
a
start
this
meeting
by
anchoring,
again
as
I
as
I
try
to
open
every
meeting
in
the
values
and
the
foundations
with
which
we
approach
this
work,
which
are
the
foundations
of
safety,
equity
and
transparency,
and
I
want
to
kind
of
remind
all
of
us
about
how
we
go
about
ensuring
those
pieces
and
really
thinking
about
the
the
in
the
face
of
a
limited
vaccine
supply
right.
B
B
Right
as
an
advisory
body
to
receive
public
comments
and
to
hear
all
of
these
questions
and
concerns,
and
then
we
take
your
comments,
concerns
and
recommendations
and
share
them
with
the
drafting
guidelines,
work
group
and
the
drafting
guidelines
work
group
are
charged
with
the
difficult
responsibility
of
making
these
recommendations
to
to
the
administration
and
we're
doing
this.
B
In
you
know:
we've
structured
this
framework
of
this
three-part,
these
three-part
groups,
after
the
recommendations
of
the
national
academies
of
sciences,
engineering
and
medicine
who,
in
their
wisdom,
recognized
that
there
would
be
intense
advocacy
for
prioritization
of
vaccines
and
really
sought
to
create
a
framework
in
which
public
and
community
voice
could
be
heard
and
incorporated
in
the
process,
while
at
the
same
time,
charging
the
responsibility
for
making
these
difficult
recommendations
in
the
hands
of
medical
and
public
health
experts
after
they
have
done
an
in-depth
review
of
the
data.
B
And
so
as
we
move
into
this
process,
I
want
to
share
with
you
our
collective
gratitude
for
the
the
robustness
of
the
recommendations
that
have
been
shared,
the
highlighting
of
the
concerns
and
really
the
way
in
which
this
group
has
helped
us
maintain
equity.
B
At
the
center
of
the
work
that
we
do,
and
I
I
want
to
state
something
explicitly-
I
believe
that
it's
been
stated
before,
but
it's
very
important
for
me
to
restate
that
when
we're
talking
about
equity,
that
includes
equity
in
terms
of
providing
service
and
accessibility
for
individuals
with
disabilities
right,
and
so
I
want
to
make
sure
that
when
we
think
about
equity,
we
absolutely
think
about
racial
and
ethnic
and
socio-economic
equity.
B
But
we
also
want
to
think
about
equity
in
terms
of
ability,
and
I
want
to
make
sure
that
that
is
stated
explicitly
at
the
beginning
of
this
meeting.
B
So
today,
as
part
of
this
meeting,
the
other
thing
that
I
want
to
do
is
you
all
have
shared
many
many
questions
in
the
chat
in
our
conversations,
and
I
want
you
to
know
that
we
are
working
very
hard
in
between
meetings
to
try
and
get
as
many
answers
as
possible
to
the
many
questions
that
you
guys
ask.
B
So
for
today's
meeting
over
the
course
of
the
of
the
presentations
and
conversations
you're
gonna
hear
we're
gonna
touch
on
we've
heard
many
questions
about
what
is
the
status
of
the
federal
long-term
care
partnership
right,
the
partnership
with
the
pharmacies,
and
so
so
we
will
speak
to
that
question.
We
hope
to
bring
you
answers
to
that.
B
You
all
asked
us
the
question
about
as
we
transition
to
an
age-based
system
from
our
blended
age
and
sector-based
system,
where
do
inmates
in
correctional
facilities,
homeless,
shelters
and
other
programs,
as
well
as
residents
of
detention
facilities,
both
public
and
private.
Where
do
they
fit
in
this
new
approach?
And
we
we
will,
I
hope,
to
bring
you
as
as
much
information
as
we
can
about
that.
B
You
ask
a
question
about
how
will
vaccine
hesitancy
among
health
care
workers
and
other
californians
be
addressed
by
the
state,
and
when
we
talk
about
engagement,
we
we're
going
to
share
some
information
about
data
on
health
care
workers
and
addressing
barriers
for
health
care
workers.
As
we
talk
about
the
overall
research
that
we
have,
that
is
informing
our
engagement
and
communication
strategies.
B
You
all
at
the
last
meeting
asked
how
will
employers
participate
in
vaccine
distribution
in
an
age-based
approach,
and
in
a
section
of
this
meeting,
we
will
hear
from
gov
ops
our
state
of
california
government
operations
about
how
we
are
operationalizing
our
vaccine
distribution
strategy,
and
in
that
we
have
asked
them
to
speak
to
this
question
about
how
employers
will
participate
in
vaccine
distribution
in
this
age-based
approach
and
the
other
question
that
we've
been
working
hard
to
make
sure
that
we
have
answers
to
respond.
To
is
folks.
B
Ask
the
question:
how
will
notification
of
individuals
about
vaccinations
work
and
we
can
share
we'll
share
a
little
bit
about
that?
We
actually
will
have
more
for
you
about
that
in
the
next
meeting,
but
as
we
move
into
this,
what
I
I
want
to
say
is
that
your
questions,
your
comments,
your
concerns,
are
heard:
we're
working
very
hard
to
bring
this
information
back
to
you
at
the
end
of
this
meeting,
we're
going
to
end
the
meeting
by
again
soliciting
your
questions
and
concerns.
B
We
try
to
pull
as
much
out
of
the
chat
as
possible
and
be
able
to
respond
to
it,
but
again,
we'll
have
cr.
We've
created
a
space
for
that,
and
so
with
that,
I
want
to
start
off
the
the
meeting
with
any
welcoming
comments
from
my
co-chair,
dr
pond,
and
then
dr
pond
will
start
with
an
update
on
vaccine
supply.
E
Great
good
afternoon,
everyone
thank
you
so
much
nadine
yeah.
I
wanted
to
start,
as
I
often
do
with
just
those
sort
of
where
we
are
as
a
state,
and
I
think
for
me.
It's
also
just
been
a
little
bit
of
a
moment
of
reflection.
We
have
just
hit
a
little
bit
over
a
year.
There's
been
a
few
anniversaries.
Recently,
the
first
you
know
cases
in
the
united
states.
E
I
remember
very
vividly
first
activating
when
I
was
at
the
local
public
health
level,
our
emergency
response
for
public
health
and
just
sort
of
starting
to
see
that
this
was
evolving
into
a
potential
emergency
and,
of
course,
in
that
moment
a
year
ago,
I
had
no
idea
who
would
be
where
we
are
now.
I
think
you
know
we
have
gone
through
a
really
huge,
difficult
surge
this
winter.
You
know
much
more
above
and
beyond.
E
I
think
what
many
of
us
would
have
imagined,
but
we've
gotten
through
that
and
I'm
very
happy
to
share
that.
We
are
very
encouraging
trends
right
now.
Our
cases
are
decreasing,
they're
actually
decreasing
quite
rapidly.
There's
been
some
decreases
in
testing,
which
made
us
concerned
that
maybe
it's
just
that
we're
not
testing
as
much,
but
we're
also
looking
at
something
called
test.
Positivity,
that's
also
improving
and
really
importantly,
hospitalizations
and
intensive
care
unit
admissions
have
all
been
decreasing,
so
those
are
great
signs
I
do
also.
E
At
the
same
time,
I
want
to
remind
people
that
we
are
still
at
levels
that
are
around
what
our
peak
was
last
july,
so
we
are
still
not
out
of
the
woods
yet.
We
are
absolutely,
thankfully,
on
the
other
side
of
this
surge,
and
things
are
definitely
getting
better,
but
as
we
lifted
that
regional
stay
at
home,
you
know,
I
think
we
still
have
a
lot
of
tight
restrictions.
But
thankfully
a
lot
of
us
can
do
a
lot
more
things,
but
we
cannot
let
our
guard
down.
E
That
being
said,
I
think
the
other
things
that
have
happened-
we've
all
endured
a
lot
over
the
last
year.
I
think
everyone
has
made
sacrifices
over
this
year
during
this
pandemic,
and
certainly
some
more
than
others
and
some
have
really
again
been
disproportionately
impacted,
but
we've
gotten
through
this
part
together,
40
million
strong-
and
there
were
times
during
that
surge,
especially
in
certain
parts
of
our
state.
Where
you
know,
health
care
was
really
stretched
to
contingent
levels
of
care.
E
E
We
managed
to
level
load
the
resources
make
sure
that
resources
were
where
they
needed
to
be
so
that
we
didn't
have
to
get
to
that
and
now
and
I
I
want
to
just
call
out
all
the
healthcare
heroes
that
really
endured
all
that
and
now
we're
here
again
with
the
light
at
the
end
of
the
tunnel,
but
it's
in
very
small
amounts.
So
we
are
we're
all
collectively
allocating
scarce
resources,
and
this
is
just
particularly
difficult
at
all
different
levels.
E
So
I
just
want
to
also
thank
all
of
you
and
your
partnership
and
the
community
and
californians.
This
committee's
input
is
extremely
valuable
to
us
and
to
all
californians,
and
we
continue
to
learn
and
grow
from
our
experience
in
this
pandemic.
I've
learned
so
much
over
the
last
year
and
you
know
we.
We
are
just
evolving
and
learning
and
we
also
really
learn
from
feedback
and
input.
So
I
want
to
thank
all
of
you
continue
to
make
us
better.
We
will
continue
to
get
better,
and
you
know
again.
E
Some
of
this
is
having
to
learn
as
we
go,
and
some
unanticipated
challenges
continue
all
the
way,
but
I
think,
all
together
again
40
million
strong.
We
we
get
through
this
together
and
we're
in
our
home
stretch,
so
really
excited
for
that.
E
Let's
see
some
of
our
numbers
and
things
like
that,
let's
see-
and
actually
we
can
stay
on
this
for
a
moment
so
I
wanted
to
just
highlight.
I
know
people
have
a
lot
of
questions
about
supply,
how
many
people
will
be
vaccinated?
How
much
are
we
getting
so
our
sort
of
numbers
about
how
many
have
been
delivered
to
california?
6.3
million
doses
have
been
delivered
to
california
and
we
have
vaccinated
almost
3.8
million
doses
to
date
and
among
those
over
600
thousand
people
have
gotten
two
doses.
E
That
means
over
a
half
million
or
over
600
thousand
people
are
fully
vaccinated
in
california
and
by
our
estimates,
and
we've
done
a
lot
of
work
over
the
last
several
weeks
to
really
improve
the
data
that
we
can
collect.
On
doses,
administered
about
two-thirds
of
our
supply
has
been
administered,
so
that
is
and
a
lot
again
people
have
been
working.
You
know
many
people
have
been
holding
on
to
second
doses
with
the
and
the
inability
to
know
exactly
how
many
doses
are
coming
in
the
next
week.
E
We
do
continue
to
hope
that
will
stabilize
over
time
we've
moved
actually
as
a
state
from
you
know,
we
were,
as
many
of
you
heard,
among
the
lowest
on
the
bloomberg
rating.
We
are
at
29th
now,
amongst
all
the
states
and
among
the
large
states,
we're
doing
quite
well
as
far
as
getting
our
vaccine
out.
E
So
again,
I
think
we
had
you
know
the
rollout
was
difficult
in
the
middle
of
a
surge
and
took
us
a
little
bit
of
time
to
be
getting
up
to
speed
and
we
know
there's
a
lot
more
capacity
as
we
talk
to
people
on
the
ground
and
as
we
set
up
you
know
all
these
various
math
sites,
I
think
really
our
limiting
factor
is
vaccine,
but
a
lot
more
capacity
has
been
increased
and
you'll
hear
more.
E
As
far
as
projections,
I
think
again
we're
still
hoping
that
that
there
will
be
more
clear
projections.
The
last
we've
heard
from
the
federal
government
is
we'll
be
able
to
get
sort
of
three-week
out
projections,
which
is
a
little
bit
better
than
the
one-week
protections,
but
we're
still
not
getting
a
lot
of
definitive
numbers
and,
of
course,
some
of
it
will
be
based
on
when
new
vaccines
are
approved
and
then
how
much
those
manufacturers
can
supply.
E
So
we
will
continue
to
keep
you
all
and
the
public
up
to
date
as
much
as
we
can
on.
You
know,
as
we
know,
ongoing
projections,
but
right
now
we're
still
in
a
very
much
a
week
to
week
basis.
E
So
with
that
I'll
move
on
to
talk
about
the
long-term
care
partnership,
you
go
to
the
next
slide.
So,
as
many
of
you
know,
we
have
a
cdc
pharmacy
partnership
for
long-term
care
facilities
and
skilled
nursing
facility
programs
go
into
the
next
slide.
Please
and
so
cvs
and
walgreens
have
partnered
nationally
with
cdc
and
here's
our
data
in
california,
so
they
have
conducted
their
plan,
is
to
schedule
and
conduct
three
vaccine
clinics
at
all
of
these
facilities
on
site.
E
So
they
first
started
the
program
for
the
skilled
nursing
facilities
that
was
part
a
on
december
28,
2020
and
then
the
assisted
living
facilities
and
other
facilities
started
on
january
11th
over
16
000,
long-term
care
facilities.
So
98
of
the
total
signed
up
have
clinic
schedules,
and
you
can
see
this
nice
graph
of
kind
of
the
waves
that
have
gone
here.
So
these
different
colors,
the
blue,
is
the
first
clinic
scheduled
and
then
the
second
and
the
third.
So
they
try
to
go
to
that.
Third
time.
E
In
case
someone
missed,
you
know
the
first
or
the
second
to
to
get
those
vaccinations
in
next
slide.
E
And
then
this
is
actually
a
cumulative
picture
to
look
at
sort
of
starting
again
at
the
end
of
december.
Moving
now
to
the
beginning
of
february,
where
we
are
so
as
of
february
2nd,
almost
350
000
doses
have
been
administered
in
these
facilities.
300
almost
300
000
have
been
first
doses
and
a
little
over
50
000,
our
second
doses,
and
then
you
can
see
the
breakdown
here
of
188
000
resident
doses
versus
159.
E
000
stop
doses,
so
I
think
we
all
know-
and
there
have
been
a
lot
of
questions
from
this
group
as
well,
that
you
know
like
the
overall
vaccine
roll
out.
I
think
there
it
was
a
little
bit
of
a
bumpy
start.
Some
of
the
challenges
that
we've
been
hearing
both
from
people
on
the
ground
and
the
pharmacy
leaders
as
well,
is
that
the
logistics
have
been
have
been
huge.
They
have.
We
have
17
000
facilities
in
california.
E
Once
again,
you
know,
just
like
all
of
our
vaccine.
Coming
out,
we
were
in
the
middle
of
our
worst
surge
ever
a
lot
of
the
rest
of
the
country
had,
you
know,
been
through
most
of
their
surge
and
it
kind
of
moved
its
way
west,
and
so
we
were
one
of
the
last.
I
think
to
get
a
huge
peak
and
it
was
right
in
the
middle
when
we
were
getting
vaccines.
E
So
you
know
there
are
recommendations
by
the
cdc
that
people
with
acute
infection
should
defer
vaccination
until
recovered
and
have
complete
isolation
and
there's
also
considerations
in
the
middle
of
an
outbreak
on
when
and
where
to
vaccinate.
E
So
our
healthcare
associate
infection
team
actually
developed
what
we
call
yellow
zone
infection
control
zones
so
that
you
know
to
be
taken
into
consideration
when
the
when
the
pharmacy
vaccinators
would
come
into
these
sites
and
how
they
could
safely
and
effectively
vaccinate
during
these
outbreaks,
but
that
you
know
led
to
some
other
logistical
challenges
about
who
could
be
vaccinated,
which
areas
of
the
facilities
they
could
be
in.
E
Data
reporting,
like
amongst
other
providers,
has
involved
many
systems,
both
new
systems
by
the
federal
government,
the
state
government
for
us
and
cbs
and
walgreens.
So
there's
been
ongoing
work
to
improve
the
data
flow
again
from
these
doses
administered
and
getting
that
to
us.
So
we
can
report
back
to
ourselves
and
to
you
and
see
how
it's
going.
So
that's
an
ongoing
work
as
well.
E
There
were
definitely
communication
issues
early
on
not
hearing
from
the
pharmacy
partners
themselves
and
into
sort
of
the
state
and
public
health
on
where
they
were,
and
then
us
need
to
communicate
that
to
local
health,
but
that's
really
improved
over
time
as
well.
There
were
a
lot
of
challenges
with
pharmacies
being
able
to
reach
some
of
the
facilities.
You
know
we
heard
that
they
were
calling
over
and
over
again
it
would
take.
E
Sometimes
you
know
several
times
actually
reach
someone
to
schedule
the
clinic
times
and
then
emails
also,
you
know
were
sometimes
ignored
and
some
thought
it
was
sort
of
a
spam
or
junk
mail.
But
again
I
we've
had
a
very
high
level
conversations.
E
I
know
representatives
from
our
governor's
office
have
met
with
you,
know
the
ceos
of
these
organizations
and
really
made
sure
that
things
are
improving
as
we
move
forward
and
we're
very
encouraged
by
all
the
progress
that's
been
made
and,
as
you
saw
from
the
prior
slide,
all
the
facilities
should
be
completed
by
mid-march.
E
So,
let's
see,
if
there's
any
other
key
things
I
wanted
to
share
with
all
of
you.
So
all
the
skill,
nursing
facilities
should
be
done
by
the
end
of
february
and
all
the
other
ones
by
the
end
of
march,
and
I
think,
interestingly
enough,
you
see
these
absolute
numbers
here.
I
think
just
to
also
I
know
a
lot
of
people
had
questions
about
this.
E
As
far
as
uptake
we've
had
really
good
uptake
among
residents,
which
is
78
among
residents
in
these
facilities,
but
unfortunately,
only
less
than
40
percent
of
staff.
Around
37
percent
of
staff
have
received
more
than
one
dose
through
this
program,
so
we
really
want
to
continue
to
work
with,
which
was
another
question
and
theme
moving
forward
about
how
we
work
on
vaccine
hesitancy
amongst
healthcare
workers
and
others.
E
So
we'll
yeah
we'll
be
continuing
to
work
on
outreach
in
that
setting
as
well
and
we'll
continue
to
keep
you
and
others
up
to
date
on
what's
going
on
with
this
program,
let's
see
next
slide.
I
think
it
might
be
yes.
So
with
that,
I
will
turn
it
over
to
my
colleague.
I
think
marta
green
might
be
next
or
paul
markovich.
B
Dr
pond,
before
we
jump
in
with
with
marta,
there
are
two
questions
that
I
see
in
the
chat.
I
don't
know
if
you
have
this
information
at
your
fingertips,
so
we
may
have
to
come
back,
but
do
you
know
how
much
supply
we
anticipate
for
next
week.
E
Next
week,
I
don't
have
it
at
my
fingertips,
so
we
we
will
get
that
to
people,
though.
B
E
Will
say
previously,
like
first
doses,
have
been
in
the
500
to
600
000
range,
and
then
you
know
continue
to
get
second
doses
to
make
up
for
those
initial
ones.
B
Thank
you
and
then
there
was
a
question
total
number
of
long-term
care
staff
and
residents.
I
think
we'll
have
to
get
back
to
you
on
that,
because
I
don't
think
we
have
that
number
at
our
fingertips.
I
do
see
that
lisa
coleman
put
some
figures
in
the
in
the
chat,
but
I
don't.
I
think
we
would
have
to
confirm
as
to
the
numbers
that
we
are
working
with
and
there's
a
question
from
mike
dark
about.
Why
is
there
still
no
state
dashboard
and
interestingly,
there.
B
We
we
did
not
have
time
in
the
agenda
to
present
it
today,
but
if
you'd
like
a
presentation
on
the
state
dashboard,
we
can
do
that
at
the
next
meeting
and
there
was
another
question:
are
the
78
percent
and
40
dr
pond
cited
national
or
state
figures?
Those
are
state
figures
for
the
state
of
california.
E
Yeah
and
the
dashboard
will
be
continuing
to
sort
of
update
and
improve
as
well.
So
it's
increasing,
but
it's
on
the
covet
19
website.
When
you
go
to
the
vaccines
page.
B
Thank
you
so
much
so
thank
you
for
those
questions
and
and
and
now
we'll
turn
it
over
to
marta
green
and
paul
markovic,
to
share
more
about
accelerating
vaccine
distribution
and
administration.
G
G
G
G
This
state,
what's
going
to
be
different
about
this,
is
the
state
will
allocate
vaccines
directly
to
providers
to
maximize
efficiency
and
also
have
real-time
transparency
into
where
vaccines
are
at
all
times?
These
vaccines
are
truly
the
most
important
and
precious
resource
that
we
have
in
california
and
we
need
to
know
where
they
are
and
how
quickly
they're
getting
into
our
communities
and,
most
importantly,
our
communities
of
color.
G
We
are
going
to
enter
into
a
cost
basis
contract.
So
what
a
cost
basis
contract
means
is
that
blue
shield
will
pass
its
actual
costs
for
administering
the
third
party
agreement
arrangement
to
us,
but
will
not
be
able
to
profit
in
any
way
off
of
this
arrangement.
G
The
network
for
the
statewide
magazine
network
will
include
providers
who
meet
various
program
requirements
such
as
the
ability
to
give
us
statewide.
Real-Time
data
meet
our
equity
goals
and
metrics
have
certain
value
capacity
capacity
targets
we're
going
to
have
a
wide
variety
of
providers
in
the
system.
It's
going
to
include
existing
health
systems,
hospitals,
clinics
pharmacies,
mobile
sites,
mass
vaccination
sites
and
and
will
also
include
home-based
vaccination
next
slide.
Please.
G
So
what
is
a
third-party
administrator,
it's
kind
of
an
archaic
term.
So
what
it
is,
is
it's
an
entity
that
selects
and
manages
a
network
that
is
responsible
for
the
delivery
of
healthcare
or
other
services
for
a
group
of
people.
I
administer
a
third
party
administrator
contract
over
at
calpers
for
our
self-funded
health
program.
They're
very
common
blue
shield
of
california,
was
selected
to
be
the
tpa
for
the
state
and
is
tasked
with
creating
that
network
a
little
bit
about
blue
shield.
You
probably
all
know
them,
but
it's
a
california
based
non-profit.
G
G
G
Those
contracts
will
include
the
ability
for
the
providers
to
receive
startup
costs,
to
do
mobile
clinics,
startup
costs
to
get
on
the
network,
startup
costs
for
mass
vaccination
sites
and
we'll
also
include
incentive
payments
for
meeting
various
metrics
that
we
set
out
and
those
incentive
payments
I'll
get
into
more
later.
But
they'll
include
things
like
real-time
data
entry
meeting
the
populations
we
are
trying
to
serve
administering
vaccines
in
the
lowest
health,
healthy
places
in
index,
quartile
and
other
various
metrics.
G
They
will
also
have
a
communications
plan
component
with
the
with
the
providers
to
help
give
them
real-time
information
about
state
expectations
regarding
tiering
regarding
policies
and
procedures,
as
established
by
our
colleagues
at
the
department
of
public
health,
they
will
oversee
the
network
and
make
sure
that
the
network
is
performing
to
state
expectation.
G
They
will
implement
the
vaccine
distribution
that
is
set
by
the
state
of
california
and
including
consideration
for
hot
spots
and
all
of
the
equity
measures
that
we'll
get
into
later,
and
then
they
will
feed
provider
data
as
required
to
myturn.ca.gov
and
statewide
dashboards.
So
there's
real-time
transparency
regarding
the
performance
of
the
network
and
the
penetration
of
vaccines
in
california.
G
So
why
are
we
doing
this
like?
What's
what?
What
are
some
of
the
challenges
we're
trying
to
fix
right?
Now
we
have
vaccine
administration
recorded
on
multiple
systems,
including
paper-based
systems.
At
some
sites
there
are
lags
and
data
reporting.
There
are
gaps
in
the
data,
that's
reported,
and
it
makes
it
very
difficult
for
the
state
to
support
real-time
decision-making
in
where
vaccines
are
deployed.
So
in
the
future
state
we
want
to
see
major
consolidation
of
the
systems.
G
Real-Time
availability
of
data
for
monitoring,
of
where
vaccines
are
as
well
as
reporting
a
user-friendly
tool
for
the
public
to
register.
We've
all
heard
the
stories
we
heard
it
in
public
comment
that
bobby
talked
about
this
morning.
People
don't
know
where
to
go
to
sign
up
to
get
a
vaccine,
and
we
want
consistent
tracking
of
follow-up
doses.
So
we
ensure
that
all
individuals
get
the
second
dose
and
achieve
that
that
safety
next
slide.
G
Please
so
how
are
we
going
to
ensure
transparency,
so
we
are
going
to
determine
and
approve
all
of
the
vaccine
distribution
criteria.
We
will
provide
these
criteria
to
our
third
party
administrator
partner
to
achieve
exportable
vaccine
allocation
based
on
population
needs
and
covet
19
burden.
We
are
going
to
report
administration
statistics,
including
all
of
those
key
metrics.
I
talked
about
such
as
volume,
geographic
distribution
and
equity
metrics
through
a
public
online
dashboard
next
slide.
Please.
G
So
what
are
our
guiding
principles?
Well,
first
and
foremost,
as
I
said
to
everybody
that
I've
talked
to
we're
here
to
save
lives.
So
that's
what
we're
here
to
do
today,
we're
here
to
save
lives,
and
how
are
we
going
to
do
that?
We're
going
to
do
it
through
equitable
distribution
of
vaccines?
That
means
targeting
vaccines
that
have
been
disproportionately
impacted
by
coven
19..
G
G
So
what
does
equitable
delivery
of
vaccines?
Look
like
all
californians,
especially
those
disproportionately
impacted
by
covid19,
have
equitable
access
to
the
cova-19
vaccine,
ensuring
that
all
communities,
urban
and
rural,
receive
equitable
allocations
of
the
vaccine
that
we
are
engaged
in
significant
education
efforts
focused
on
awareness,
and
we
want
to
achieve
high
vaccination
rates
in
all
communities.
G
So
how
are
we
going
to
achieve
this?
It's
a
big
goal,
so
there's
going
to
be
a
number
of
elements
to
the
tpa
arrangement
that
I
want
to
highlight.
The
first
is
we
are
going
to
have
pay
for
performance
payments
for
vaccinating
individuals
living
in
the
lowest
hpi
quartile
census,
tracts
we're
going
to
have
payments
to
providers
for
vaccinating
communities
of
color,
we're
going
to
have
payments
for
targeted
outreach
and
engagement
efforts
to
ensure
that
our
target
communities
are
getting
vaccinated
and
also
enhanced
payments
to
facilitate
evening
accessibility,
translation,
physical
transportation
services.
G
H
Thank
you
martyr.
I
appreciate
it
and
I
want
to
start
by
thanking
everybody.
H
It's
not
meant
to
be
a
comprehensive
list
of
examples,
but
I
just
wanted
to
say
how
thankful
I
am
for
all
of
you
and
the
organizations
and
the
people
that
you
represent
for
truly
inspiring
heroic
acts
that
we're
we're
seeing
every
day.
I
also
know
that
all
of
this
effort
has
taken
a
toll.
You
know
we're
we're
suffering
from
individual
and
collective
exhaustion.
We
just
want
this
to
be
over
right
now
and
I
think,
there's
great
hope
in
getting
to
that
place
with
these
vaccines.
H
It
will
certainly
take
a
village
to
make
this
work.
So
I
wanted
to
spend
just
a
little
bit
of
time
up
front
talking
about
why
blue
shield
is
taking
on
this
role
and
then
how
we
plan
to
approach
it
bear
in
mind.
I
think
this
is
our
sixth
day
on
the
job,
so
we
don't
have
answers
to
all
of
your
questions,
but
we
will
get
there
soon
if
we
can
move
to
the
next
slide.
I
just
wanted
to
start
with
a
few
slides
with
an
apology
in
advance.
H
This
is
not
meant
to
be
an
infomercial
about
blue
shield,
but
I
think
there's
some
background
about
blue
shield
that
provides
helpful
context,
we're
a
non-profit
mission,
driven
organization.
We
are
here
to
create
a
health
care
system,
that's
worthy
of
our
family
and
friends
and
sustainably
affordable
for
everyone
and
the
best
way
we
can
serve
that
mission.
H
Right
now
is
to
get
as
many
people
vaccinated
as
possible,
and
so
that's
exactly
what
we
we
plan
to
do.
The
other
thing
we
bring
to
the
table,
in
addition
to
motivation
to
help
is
that
we
manage
large
physician
hospital
and
pharmacy
networks
across
the
state
in
all
58
counties.
So
developing
and
managing
a
network
is
in
fact
what
we
do
every
day
as
a
part
of
our
business.
H
If
we
can
move
to
the
next
slide.
It's
also
true
that
we
have
a
history
of
of
partnering
with
the
private
sector
and
the
public
sector
on
industry
initiatives,
and
many
of
you
probably
know
that
I
volunteered
to
co-chair
the
governor's
copa
19
testing
task
force.
Last
year,
we
managed
to
increase
the
average
testing
from
about
2
000
tests
a
day
to
over
100
000
tests
a
day
in
the
in
a
little
less
than
than
three
months.
H
We
also
have
worked
closely
with
organizations
like
la
care
to
establish
a
network
of
community
centers
available
to
everybody
in
the
community,
but
targeted
to
the
medi-cal
population.
In
los
angeles,
we
put
50
million
dollars
into
an
effort,
we've
partnered
with
the
integrated
health
care
association
to
try
to
do
a
common
portal
for
physician
credentialing
and
we're
working
with
the
part
california
department
of
education
on
our
blue
sky
initiative
to
improve
access
to
behavioral
health,
again,
not
a
comprehensive
list,
but
just
meant
to
say
that
we.
H
We
can
move
to
the
next
slide,
we're
talking
a
lot
about
equity,
and
I
like
to
quote
ralph
waldo
emerson
when
he
said
what
you
do
speaks
so
loudly
that
I
cannot
hear
what
you
say.
So
I
can
talk
to
you
a
lot
about
equity,
but
I
think
what
you're
going
to
believe
is
what
we
do
and
I
just
wanted
to.
H
You
know
diversity,
equity
and
inclusion,
just
core
principles
to
us.
We
work
on
them
every
day.
We
are
not
perfect,
but
we
have
been
widely
recognized
for
doing
a
lot
of
good
work
in
this
area,
including
being
rated
by
diversity
inc
as
the
top
regional
company
for
diversity,
and
we've
had
for
several
years
running
now,
no
gap
in
pay
between
minorities
and
non-minorities
at
blue
shield
or
between
men
and
women.
So
again
we
have
a
lot
of
work
to
do
still
in
this
space.
H
H
We
need
to
track
all
vaccines
from
order
to
injection,
as
I
said,
to
the
team,
if
there's
a
truck
on
the
side
of
the
road
with
a
vaccine
in
it
just
outside
of
fresno,
we
need
to
know
that
and
it's
these
are
such
valuable
commodities
that
are
so
important
that
the
only
way
to
maximize
performance
is
to
know
at
all
times
what
performance
is
we
have
to
understand
who's
getting
vaccinated
and
to
ensure
that
there's
equity
in
that
distribution
and
administration?
H
We
need
to
receive
comprehensive,
accurate,
same-day
data,
and
we
need
to
report
it
in
a
detailed
and
transparent
way.
That's
what
we
need
to
put
together
and
if
you
move
to
the
next
slide,
that's
not
it's
not
the
only
thing
we
need
to
do.
Putting
together
that
rigorous
system
and
marta
explained
a
little
bit
of
what
we'll
need
to
change
to
make
that
happen
is
is,
is
baseline
and
foundational,
but
then
we
need
to
partner
with
key
stakeholders,
particularly
on
the
ground
in
local
communities.
H
In
order
to
to
be
successful,
we
can
build
and
we
will
build
a
high-performing
network,
but
if
we're
going
to
achieve
things
like
equity,
just
to
give
you
an
example,
there
there's
a
lot
of
evidence
and
a
lot
of
anecdotal
stories
about
setting
up
sites
in
target
communities,
communities
of
color
places
that
are
higher
risk,
but
having
a
lot
of
people
drive
from
a
long
ways
away
to
go
to
that
site
and
receive
a
vaccine.
H
So
we
don't
consider
it
a
success
to
set
up
a
network
that
has
sites
accessible
in
target
communities
having
a
vaccine
administered.
There
is
not
success,
getting
the
communities
that
are
the
highest
risk
that
help
us
save
the
most
lives
is
success
and
we
need
help
with
that.
We
can
set
up
a
high
performing
network
and
we
can
manage
it,
but
we
really
need
the
people
who
know
these
communities
that
are
trusted
by
them,
who
understand
how
to
get
people
to
believe
it's
okay
to
to
coordinate
with
them
to
get
them
to
access
this
network.
H
That's
where
we're
really
going
to
be
ultimately
successful
and
we
are
going
to
need
to
be
creative
and
innovative
and
partner
with
a
lot
of
folks,
including
many
of
you
on
this
call
to
to
make
it
work.
We
can
move
to
the
next
slide.
Please
so
what's
happening
now.
We
really
talk
about
this,
often
in
three
phases,
and
and
really
it's
just
the
first
two
phases
that
matter
the
most.
The
first
phase
is
right.
Now,
nothing
specifically
is
changing.
We
do
not
have
this
new
process
up
and
running
or
designed.
H
So
what's
key
right
now
is
to
keep
performing
at
the
highest
level.
We
possibly
can
vaccinate
as
many
high
priority
people
that
have
been
determined
through
the
prioritization
process,
vaccinate
as
many
of
them
as
possible
and
report
that
data
comprehensively
and
as
timely
as
possible,
and
to
just
keep
doing
the
best
that
we
can
with
what
we've
set
up
at
this
point
and
support
the
folks
that
are
doing
that
work.
That's
the
most
important
thing
we
can
do
right
now
in
the
short
term.
H
If
we
go
to
the
next
slide,
the
next
phase
we
have
to
get
to
is,
we
have
to
be
ready
to
accelerate
the
rate
of
vaccinations.
Our
job
is
to,
however
much
vaccine
comes
into
the
state.
We
need
to
be
able
to
get
it
out
there
get
into
people's
arms,
have
as
minimal
waste,
hopefully
none,
but
as
the
minimum
waste
we
can
possibly
imagine
and
ensure
that
we
are
get
people
are
getting
vaccinated
in
the
priority
order.
H
H
Our
game
plan
is
to
start
introducing
that
new
network
later
this
month
and
to
phase
it
in
over
multiple
weeks
and
so
that
that's
what
we're
hoping
to
do,
obviously
we're
just
in
our
sixth
day,
there's
still
a
lot
of
work
to
do
so.
We're
not
giving
quite
definitive
dates
yet
because
we
still
don't
know
everything
that
we
need
to
know
and
we
still
haven't
had
the
conversations
that
we
need
to
have
with
all
of
you.
H
So
that's
that's
what
you
should
expect
next,
that's
what
we're
working
on
is
completing
this
design
and
then
setting
up
that
that
conversation
in
that
dialogue,
and
with
that
I
look
forward
to
working
with
all
of
you
and
I'll
turn
it
back
to
I'm
not
sure
exactly
whether
it's
dr
dr
pan
or
who's
who's
facilitating
but
I'll
turn
it
back
over
to
the
facilitator
for
questions.
B
I'll
go
ahead
and
jump
in
here
paul.
Thank
you
so
much.
Thank
you
to
paul
and
marta
for
that
for
that
presentation,
and
I
I
want
to
start
off
by
responding
to
some
of
the
questions
that
have
come
up
in
the
chat.
So
there
are
a
couple
of
questions
that
come
up.
B
One
is
whether
or
not
our
our
dashboard
is
going
to
be
able
to
report
race
and
ethnicity
data
and,
as
another
question
by
by
mike
dark,
was
asking
the
question
about
the
uptake
among
staff
and
residents
in
in
long-term
care
facilities.
There
was
a
question
about
being
able
to
for
consumers
to
be
able
to
do
that,
quick
questions
so
for
I'm
going
to
ask
really
quickly,
dr
ponn,
I
know
that
we
do
have
a
plan
to
report
race
and
ethnicity
data,
but
that's
still
in
process.
Do
you
wanna.
E
Yeah,
I
can
start,
I
think
it's
absolutely
like,
for
example,
in
our
california
immunization
registry
and
the
other
two
registries.
I
believe
that
is
a
field.
I
think
my
initial
understanding
is
like
early
on
in
the
pandemic.
There's
a
lot
of
missing
data,
but
we
are
definitely
working
to
to
report
that
as
soon
as
possible,
but
I
think
we're
going
to
also
need
to
work
on
improved
collection
and
part
of
the
new
sort
of
data
accountability.
I
believe,
would
be
to
improve
that
that
field
as
well.
H
If
I
may
just
add
one
thing
I
and
this
would
be
a
request
on
the
partnership
side,
I
watched
the
president
biden's
team's
presentation
earlier
this
week
and
apparently
nationally
we're
only
receiving
ethnic
data
on
around
half
of
the
vaccinations,
and
so
one
of
the
things
we
will
have
that
as
a
as
a
field.
We
will
capture
it.
We
will
report
it,
but
we
have
to
convince
people
that
it's
okay
to
share
it
and
that's
where
I
think
we
could
use
a
lot
of
getting
trust
in
the
process.
B
Thank
you,
and-
and
so
you
know
paul
as
you're
as
you're
building
the
system
right.
What
what
it
sounds
like
what
I'm
reading
in
the
chat
and
what
I
want
to
lift
up
from
this
conversation,
is
that
what
we're
hearing
is
that
folks
want
to
see
data
on
that
includes
counties,
cities,
zip
code
occupation,
certainly
race
and
ethnicity.
B
So
that
is
that's.
Those
are
a
big
care
about
something
for
you
to
to
keep
in
mind
as
you,
you
all
are
building
the
system.
I
also
want
to
speak
to
a
a
question.
There
was
there's
quite
a
a
bit
of
chat
about
equity
versus
volume
right,
and
this
is
something
that
I
know
that
I
have
been
fielding
a
lot
of
questions
about
in
the
press
as
well.
Can
you
can
you
share
with
us
a
little
bit
more
about
your
plan
to
engage
with
community
health
centers?
B
We
recognize
that
community
health
centers
are
the
trusted
source
of
care,
especially
for
individuals
who
are
uninsured.
So
for
can
you
tell
us
how
you're
you're
thinking
about
engaging
with
community
health,
centers.
H
H
We
need
to
be
able
to
work
with
a
network
that
we're
very
confident
can
handle
that
and
can
also
make
sure
that
they're
administering
pretty
much
all
the
doses
and
that
there
isn't
there
that
waste
is
not
there
at
the
same
time,
there's
a
number
of
situations
where,
if
you're
going
to
reach
these
communities
and
make
it
work,
you
have
to
have
a
level
of
flexibility
and
feed
on
the
ground
and
a
lot
more.
You
know
local
reach,
and
so
somehow
I
think
the
the
part
that
I
I
feel
like.
H
We
need
the
most
help
with
is.
We
can
get
these
we're,
probably
going
to
need
to
work
together
to
figure
out.
Where
could
these
sites
be?
How
could
we
use
resources
like
at
home
visits
and
mobile
sites,
mobile
sites,
pop-up
sites
and
and
work
with
people
on
the
ground
that
really
know
that
community
to
make
sure
that
we're
both
we
have
a
supply
chain
where
we're
not
wasting
any
of
this,
but
we're
actually
getting
to
those
communities
and
vaccinating
them.
H
B
I-
and
I
I
want
to
add
to
that
comment,
because
I
do
think
that
there
is
often
perceived
that
equity
and
and
volume
are
at
odds
with
each
other,
and
one
of
the
pieces
that
I
think
is
key
for
everyone
to
understand
is
that
one
of
the
things
that
california
is
is
also
seeking
to
achieve
is
is
we're
working
with
a
recognition
that
you
know
we've
heard
from
the
federal
government
that
they
allocate
vex.
They
consider
the
rate
at
which
we
are
getting
vaccines.
B
You
know
into
arms
administering
vaccines
as
part
of
their
allocation
considerations,
and
so,
as
we
are
thinking
about
and
again,
I
think
that,
from
the
beginning
of
this
process,
equity
has
been
at
the
center
and
I
think
the
fact
that
we
are
including
pay
for
performance
around
equity
as
part
of
the
considerations.
B
Part
of
the
things
that
we
are
asking
holding
holding
blue
shield,
accountable
for
and
holding
our
vaccinators
accountable
for,
I
think,
is
really
key.
But
I
also
want
to
highlight
how
important
it
is
that,
when
the
the
the
faster,
what
we're
understanding
is
we're
working
under
the
belief
that
the
faster
we
get
vaccines
out,
the
faster
we
get
vaccines
in
and
when
we
talk
about
moving
through
our
out
our
systems
right
moving
through
our
our
prioritization.
B
When
we
talk
about
you
know
how
do
we?
How
are
we
ensuring
that
we're
bringing
vaccine
to
the
the
moving
quickly
through
the
groups
that
are
prioritized
so
that
we
can
get
to
the
next
group
and
the
next
group
and
the
next
group,
so
that
we
can
make
sure
that
as
many
californians
are
getting
access
to
vaccine
as
quickly
as
possible?
B
I
it
we
are
working
very,
very
hard
to
make
sure
that
we
can
get
those
vaccines
out
the
door.
And
I
think
that,
as
what
we
saw
from
dr
pon
put
in
the
chat
that
it
looks
like
in
response
to
someone's
question.
It
looks
like
for
the
next
two
weeks,
we'll
be
getting
a
million
doses.
Is
that
correct,
dr.
E
Yes,
that's
right
so
around
between
five
and
six
hundred
thousand.
Those
are
first
doses
for
new
people,
and
then
the
I
mean
when
we're
trying
to
get
again
away
from
second
house,
but
keep
in
mind.
We
need
to
catch
up
on
the
second
doses,
for
all
the
people
that
have
already
been
vaccinated,
so
that.
B
What
we
see
is
that
we
have
been
you
know,
really
moving
getting
these
vaccines
out
so
that
we
can
get
access
to
vaccine
to
as
many
individuals
as
possible.
But
I
think
the
point
is
made
right,
and
this
is
why
we
need
to
work
very
closely
with
our
our
local
health
department,
whose
bread
and
butter
is
caring
for
the
safety
net
right
to
make
sure
that
we
are
vaccinating
our
most
vulnerable
communities
and
we're
not
just
saying
it's
a
nice
to
have.
B
We
are
putting
accountability,
paper,
performance
incentives
and
contractual
language
around
that
to
ensure
that
our
most
vulnerable
californians
are
getting
vaccinated.
So
I
just
wanted
to
to
speak
to
many
of
those
pieces
in
the
in
the
chat
and
if
folks
have
additional
questions,
I
I
I
don't.
I
can't
go
through
every
question
in
the
chat
because
there's.
B
A
K
Hi
andy
imperato
with
disability
rights,
california,
two
questions,
one
for
paul
when
you
guys
are
capturing
demographic
data,
I
would
strongly
encourage
you
to
include
letting
people
self-identify
that
they
have
a
disability
or
chronic
health
condition.
I
recognize
that
you're
not
going
to
get
perfect
data,
but
some
data
is
better
than
no
data
and
then
for
the
state.
My
question
is:
can
we
give
a
differential
payment
with
an
equity
goal
for
folks
that
are
affirmatively
trying
to
find
people
with
disabilities,
or
you
know
high-risk
disabilities
to
get
the
vaccine
to
those
population.
G
Thanks,
I
think
that's
a
great
idea.
Andy.
Let
me
take
that
back
as
we
develop
all
of
our
p4p
payments.
My
goal
is
to
bring
to
you
what
that
would
look
like,
maybe
at
our
next
conversation
and
so
and
if
it's,
if
it,
we
can't
do
it
here
in
the
setting
because
of
timing
because,
as
we
said
you
know,
paul
said
it
was
day
six
for
him
it's
day,
eight
for
me
so
or
nine,
so
we're
we're
all
standing
this
up
very
very
quickly.
G
So
if
we
can't
do
it
at
in
person
at
a
setting
that
maybe
we
can
get
feedback
electronically
on
that
allocation
criteria,
so
I
think
that's
that's
a
really
good
one.
A
L
You
bobby
diana
television
torres
executive
director
of
the
ufw
foundation.
You
know
we
really
appreciate
that
the
state's
developing
plans
to
accelerate
vaccination
and
having
a
coordinated,
statewide
practice
a
process.
You
know
we
do
have
very
large
concerns
about
the
federally
qualified
health
centers,
not
you
know
not
utilizing
their
capacity.
L
What
does
that
truly
mean
and
performance
management?
We
need
to
ensure
that
we
have
a
centralized
way
to
reach.
Farmworkers
ucsf
study
shows
that
you
know
agricultural
workers
have
the
highest
risk
of
death,
and
so
we
really
want
to
ensure
that
there
is
a
structured
intentional
way
to
both
allocate
vaccine
to
agricultural
workers
to
the
most
vulnerable
and
ensure
that
those
are
being
administered
by
the
most
trusted
partners
on
the
ground
which
don't
tend
to
be
large
hospitals.
L
G
Thank
you
for
those
comments.
I
think
that
they're
right
on
and
just
to
be
clear.
I
view
the
community
health
centers
and
the
federally
qualified
fqhcs
to
be
a
key
partner,
and
I
think
that
we
should
get
folks
on
the
network
and
we
are
committed-
and
I
would
invite
paul
to
to
speak
up
too,
to
help
get
them
on
the
network,
especially
if
they're
in
strategic
areas
that
can
help
us
meet
our
our
equity
goals.
G
So
absolutely
I
see
them
as
a
key
partner
in
network
development,
just
as
they
as
the
as
the
county
health
jurisdictions
will
be
as
well
paul.
I
don't
know
if
you
want
to
add
yeah.
H
No,
I
I
I
agree
with
all
of
that.
I
think
the
only
thing
I'd
say
is,
and
this
is
where
the
dialogue
is
really
going
to
be
important,
our
ability
to
move
quickly
and
ensure
efficacy.
H
It
may
be
a
lot
easier
to
work
with
the
fqhcs
in
the
community
health
centers
and
put
the
a
testing
facility
right
across
the
street.
That's
just
managed
separately,
but
is
done
in
coordination
with
you
than
it
is
necessarily
to
have
every
single
community
health
center
and
every
single
fqhc
get
trained
on
a
new
process.
H
I'm
not
telling
you
what
I
think
the
answer
is
going
into
this.
I'm
just
saying
that
I
think
they're
clearly
going
to
be
we're
going
to
do
what
we
can
to
make
them
a
part
of
the
network
and
make
this
a
part
of
the
process,
but
it
there
may
be
other
ways
to
solve
this
problem
that
allow
us
to
both
have
the
performance
at
the
statewide
level
that
we
were
just
talking
about
and
partner
with
the
community.
So
we'll
figure
that
out
together.
A
Thank
you,
diana
ronnie,
it
looks
like
you
put
your
hand
down.
Do
you
still
want
to
make
a
comment?
Yeah.
M
I
do
I
was
just
helping
you
so
ronnie
kelly,
county
behavioral
health
directors
association.
M
M
They
are
populations
like
those
I
represent,
who
have
serious
mental
illness
or
addiction
who
do
not
go
to
a
network
of
physicians,
those
people
who
are
without
homes,
those
groups
we've
been
all
working
to
try
and
target
them,
specifically
in
our
current
system.
So
is
this
the
blue
shield
tpa
in
addition
to,
or
is
this
going
to
be,
instead
of
the
current
way
we're
distributing.
G
So
we
we
are
centralizing
the
distribution,
but
many
of
the
network
providers
that
are
currently
in
the
the
county
based
system.
We
will
credential
for
the
the
new
statewide
system,
so
there
is
a
change.
I
don't.
I
don't
want
anybody
to
misunderstand
that
we
are
transitioning
to
a
state
decided
allocation
system.
G
However,
we're
going
to
build
on
the
network,
that's
already
been
created
that
can
deliver
the
vaccine
to
our
various
communities
and
provide
the
p4p
payments
that
incentivize
that
delivery
system,
but
I
am
also
not
going
to
promise
that
every
single
provider,
that's
in
the
current
network,
is
going
to
be
in
the
network
in
the
after
condition.
I
don't.
I
don't
want
to
make
a
false
promise
so,
but
we
are
going
to
work
closely
with
our
county
health
partners
to
get
those
providers
that
can
reach
those
key
populations
just
like
the
ones
you
described.
G
Those
are
the
ones
that
I
have
heartburn
about
that
we
can
make
sure
we
get
vaccines
in
those
folks
as
quickly
as
possible.
So
we
can
save
as
many
lives
as
possible.
A
Thanks
ronnie
and
marta.
Thank
you.
We
have
time
for
one
more
comment:
andy
patterson
in
this
section
of
the
agenda,
so
I
know
many
of
you
have
many
other
comments
to
make.
If
you
could
put
them
in
the
chat,
we
will
record
them
and
make
sure
that
not
only
do
you
get
to
see
them,
but
marta
and
paul
will
get
them
as
well.
After
the
meeting
andy.
N
Great
thanks
bobby
so
I
I
I
contextualized
my
comments
with.
N
I
know
everybody
who's
at
the
state
and
on
the
ground
is
working
so
hard
so
many
hours
and
is
trying
their
best
in
an
impossible
situation
and
we're
not
going
to
be
perfect
in
any
of
this
and
so
kudos
to
all
of
the
work
and
the
recognition
quickly
that
we
have
to
change
systems.
We're
supportive
of
that.
I'm
with
the
community
health
center
cpca.
N
But
I
just
I
really
I'm
starting
to
I've,
been
trying
to
be
as
patient
as
possible
and
have
been
so
excited.
I've
been
supportive
of
the
new
administration
and
all
his
commitment
to
equity
and
the
team
that
he
has
brought
in
and
all
of
that
and
they're
great
people,
but
we're
starting
to
not
see
action
on
the
equitable.
We're
just
talk
about
equitable
all
the
time
and
health
centers
haven't
been
as
strongly
as
part
of
this
network
and
the
conversation
as
we
needed
to
be
health.
Centers
were
created
specifically
for
equity.
N
We
were
put
into
locations
for
equity
and
to
build
relationships
and
trust,
and
now
they
serve
7.4
million
people
in
california.
One
in
three
medical
beneficiaries,
one
in
six
californians,
they
have
built
a
legacy
of
trust
and
they
they
have
for
traders,
they
have
teams,
they
know
how
to
do
vaccines
and
we
haven't
been
leveraged.
The
biden
team
has
a
whole
plan
on
fqhcs
as
partners,
and
we
still
haven't
been
leveraged.
We
cannot
volume
and
equity
are
not
equal
things
and
we,
it
might
be
messy.
N
Equity
is
messy
and
it's
slow
and
it
takes
onesie
twozies
across,
and
we
think
our
main
point
is
that
every
single
fqhc
or
health
center
community
clinic
should
be
able
to
contract
with
the
tpa
and
should
receive
an
allocation.
Even
if
it's
slow,
I'm
not.
I
certainly
am
not
discounting
paul
your
point
about
a
clinic
across
the
street
and
if
it's
coordinated
but
centrally,
we
have
systems
in
place
they're
not
as
pretty
and
they're
harder
to
work
with,
because
we're
not
under
one
corporate
head
but
we're
here
and
we
know
how
to
do
it.
N
A
Thank
you
andy
and
I'll
turn
the
mike
back
to
dr
pond
and
dr
burkharis.
B
Thank
you
so
much
bobby
and
and
now
we're
going
to
go
ahead
and
move
forward
to
hear
the
updated
recommendations
from
the
drafting
guidelines.
Work
group.
B
And
for
that
we
will
have
dr
rob
schechter
and
dr
oliver
brooks,
who
are
the
co-chairs
of
the
drafting
guidelines,
work
group
and
in
transitioning
from
an
age
and
sector-based
approach
to
a
more
age-focused
approach.
It
was
really
important
to
us
to
continue
to
use
this
three-part
framework
by
engaging
all
of
you
as
members
of
the
community,
so
that
we
could
hear
your
input
and
share
your
questions
and
concerns
with
the
drafting
guidelines.
B
Work
group
we
have,
we
have
shared
all
of
your
we've,
been
very
grateful
to
receive
all
of
your
input
and
concerns,
and
we've
shared
this
with
the
drafting
guidelines.
Work
group.
So
now
I'd
like
to
turn
it
over
to
dr
schechter
and
dr
brooks
to
report
on
their
findings
and
recommendations.
O
Thank
you
good
afternoon,
everybody
and
again
a
a
privilege
to
be
able
to
talk
with
you
about
what's
been
going
on
at
our
work
group
in
the
aftermath
of
some
of
the
changes
in
the
guidelines,
there
were
questions
coming
from
you
and
from
the
public
about
where,
where
some
of
the
groups
were
prioritized,
and
so
the
state
is
brought
to
the
work
group,
the
question
of
specifically
questions
around
where
in
the
prioritization
now
are
persons
with
underlying
medical
conditions
and
persons
with
disabilities
across
a
spectrum
of
disabilities
to
try
and
inform
the
conversation.
O
So
as
a
quick
recap
for
national
recommendations
under
the
federal
advisory
committee
of
immunization
practices,
persons
with
high-risk
medical
conditions
and
disabilities
are
categorized
in
phase
1c
and
represents
because
of
the
how
common
some
of
these
high-risk
conditions
are
constitute
a
large
proportion
of
the
population,
whether
nationwide
or
statewide
in
california.
O
To
as
well
as
looking
looking
forward
to
these
groups
again
revisiting
the
risks
and
those
are
medical
conditions
or
disabilities,
we
also
looked
at
the
groups
that
have
been
prioritized
so
far
and
again.
The
data
around
risk
by
age,
which
shows
up
again
and
again
as
a
is
a
strong
risk
factor
for
severe
severe,
including
fatal
coping
19
disease.
O
So
this
data
from
as
national
statistics
shows
the
tremendous
increase
in
it
with
advanced
age
and
risk
of
severe
fatal
disease,
in
this
case
fatal
disease
with
those
starting
it
at
as
early
as
as
middle
age,
but
especially
age,
65
and
older
and
and
at
age,
80
or
85,
plus.
A
tremendous
increase
in
risk
next
slide.
Please,
and
this
graph,
which
I
think
we've
shared
before
in
this
in
this
committee,
shows
compared
to
18
and
29
year
olds.
O
Age
related
risk,
either
for
hospitalization
or
death
and
against
the
risk
increasing
starting
at
30
years,
but
much
more
so
at
50,
especially
at
65
and
older.
As
the
basis
for
the
discussion
and
the
prior
discussion
around
prioritization.
The
inclusion
of
that
risk
group
in
national
and
state
prioritization
recommendations.
O
Next
slide,
please
so
with
that
as
a
as
a
point
of
comparison
with
tenfold
or
even
hundredfold
risk
in
advanced
age,
the
risk
the
working
group
also
looked
at
other
risk
factors.
In
this
case.
This
is
cdc
data
on
risk
by
race
and
ethnicity
and,
depending
on
the
group
and
the
geographic
setting
over
the
course
of
pandemic
somewhere
in
the
somewhere
in
the
range
of
twofold
to
fivefold,
risk
of
either
hospitalization
or
death
in
native
populations,
african-american
populations
or
latinx
populations.
O
This
is
hospitalization
related
data
and
for
other
conditions,
risk
anywhere
between
a
similar
risk
to
to
other
populations
for,
say
copd
and
this
one
study
for
hospitalization
higher
in
other
studies,
but
within
this
three-fold
risk
overall
on
the
bottom
line,
a
range
of
somewhere
between
one
to
four-fold,
one
to
four-fold
risk
of
hospitalization
or
death
in
various
studies.
O
And
going
back
again
to
national
and
cdc
related
data
that,
on
the
top
in
the
red
box,
you
can
see
age-related
effects
in
this
case
against
hospitalization
or
death
death
and
those
hospitalized.
So
for
those
who
are
hospitalized
of
these
age
groups,
what
was
their
risk
of
dying
up
to
11
fold
for
the
oldest
in
in
our
society
and
then
comparing
that
to
to
gender
or
disease
based
risks
of
death,
and
this
data
from
early
on
in
the
pandemic.
O
O
What's
difficult
to
tease
out
in
this
slide
is
the
role
of
age
along
with
these
these
conditions
and
that
most
of
these
severe
severe
illnesses
were
occurring
in
again
in
the
oldest
members
of
society.
O
So
then,
shifting
from
persons
with
underlying
medical
conditions
to
persons
with
disabilities,
this
is
one
of
a
few
studies
that
were
reviewed
by
the
work
group
in
its
disc,
its
recent
discussion.
O
This
is
data
based
on
covid
illness,
which
is
the
column
that
says
cases
or
case
rate
in
the
middle
of
the
middle
columns
of
the
slide
and
then
over
on
the
right
hand,
side
there's
a
fatality
rate
so
looking
at
covet
illness
and
covet
death,
comparing
californians
who
are
not
currently
receiving
disability
services,
idd
services
with
those
who
are
receiving
services,
but
this
is
broken
down
by
various
settings
or
various
settings
of
care
or
residence.
O
The
work
group
was
reviewing
this
data
in
terms
of
comparing
those
who
are
not
receiving
services,
so
average
rates
statewide
along
with
those
receiving
services
and
thinking
about
the
thinking
about
the
congregate
settings
or
residential
settings
that
are
already
eligible
for
receipt
of
vaccine
under
the
phase
1a
guidelines
for
care
facilities
for
those
who
are
older
or
medically
frail,
and
so,
if
you
look
at
the
very
bottom
in
skilled
nursing
facilities,
have
the
very
highest
rates
of
of
case
rates
and
death
rates.
O
Those
in
icfs
are
community
care
facilities
at
progressively
lower
rates,
but
still
increased
over
the
the
rate
of
the
the
death
rate
of
41
for
100
000
and
then,
in
contrast
to
the
increased
rates
for
those
being
carried
in
congregate.
Settings
in
this
study,
those
who
are
residing
in
their
own
home
or
family
home,
while
there
certainly
were
cases
and
deaths
in
in
these
persons
that
the
rates
were
lower
than
those
even
in
congregate,
settings
or
lower,
even
than
those
on
average,
who
weren't
receiving
services
next
slide.
Please.
O
The
work
group
looked
at
two
additional
studies,
one
on
claims
data
nationwide
done
by
dr
mccarty
at
johns
hopkins
and
a
data
on
rates
and
disabilities
in
the
united
kingdom,
which
both
indicated
a
two
to
threefold
risk
of
mortality
in
persons
with
disabilities
compared
to
those
without
in
the
uk,
data
90
or
so.
The
persons
who
died
with
disabilities
were
65
years
of
age,
and
in
both
these
studies
there
was
limited
data
to
distinguish
whether
persons
with
disabilities
would
also
be
considered
as
persons
with
underlying
medical
conditions.
Based
on
on
having
multiple
conditions.
O
So,
towards
the
second
bullet
from
these
from
these
other
two
studies,
it
challenging
to
assess
what
the
risk
is
for
those
who
are
currently
excluded
by
the
current
immunization
prioritization
guidances.
What
is
the
risk
for
those
under
65
years
of
age
and
what
is
the
risk
for
those
residing
outside
of
congregate
care?
O
In
contrast,
the
data
from
the
california
study
again
suggested
a
decrease
in
average
risk
to
those
residing
outside
of
congregate
settings,
and
so
it
led
to
discussion
by
the
group
of
how
much
of
this
observed
risk
this
two
to
three-fold.
Risk
of
mortality
also
reflects
additional
underlying
medical
conditions.
O
O
So
now
I'm
going
to
hand
it
over
to
dr
brooks
and
appreciate
your
attention
and
again,
I
think,
speaking
on
behalf
of
the
work
group
certainly
are
aware
of
the
concerns
of
those
who've
asked
ask
this
committee
and
and
the
state
about
where,
where
are
they
in
the
pirating
scheme
and
how
valued
are
their
lives
and
their
concerns
and
and
the
work
group
is
certainly
taking
those
those
concerns
seriously
and
with
that,
I
will
pass
it
over
to
dr
brooks
all
right.
P
Thank
you,
dr
schechter,
and
thank
you
sergeant,
general
berg,
harris
and
dr
pan
for
chairing
this
community
vacation
advisory
committee
meeting.
So
the
workforce,
the
drafting
guidelines
work
group
met,
and
these
this
is
where
we
came
up
in
synopsis,
summary
fashion,
so
phase
1a
continue
and
complete
immunization
of
healthcare,
workforce
individuals
and
those
that
reside
in
long-term
care
facilities
or
adult
assisted
living
facilities.
P
P
These
were
the
three
essential
worker
subgroups
that
had
the
highest
risk
in
our
opinion,
for
having
societal
impact
if
they
are
infected
they're
out
there
they're
in
the
front
they're
exposed,
but
they
may
have
some
effect
on
the
on
the
economy
and
then
looking
at
the
bullet
three.
P
P
So
we
know
that
that's
not
as
easy
to
determine
like
in
a
large
vaccine
setting.
So
this
applies
to
settings
such
as
healthcare
systems
or
other
clinics,
but
not
mass
clinics
or
other
local
health
department
clinics,
and
it
applies
where
the
underlying
conditions
or
disabilities
can
be
verified
through
access
to
medical
records.
P
P
Implementation
plan
should
include
outreach
and
assistance,
which
you
all
have
mentioned,
that
we've
heard
from
you,
so
individuals
have
barriers
to
making
appointments
for
vaccine
or
access
to
the
vaccine,
and
these
groups
are
prioritized
after
phase
1b
tier
1,
due
to
their
large
numbers
and
competitive
aggregate
risk
of
severe
outcomes.
P
So
this
is
why
we
really
feel
they
are
that
important,
and
then
there
is
an
alternative
proposal
that
limits
eligibility
to
individuals
with
multiple
either,
for
example,
greater
than
three
underlying
conditions
that
was
raised
also
because,
as
you
saw
from
the
data
that
dr
scheckter
presented,
have
a
very,
very
high
rate,
more
than
80
percent
of
the
deaths.
P
I
would
say
that
hearing
what
blue
shield
is
to
deliver
for
the
state
is
encouraging,
with
their
desire
to
ship
directly
to
the
vaccinators,
to
be
working
on
equity,
to
document
race
and
ethnic
data
and
to
have
real
time
the
way
it
looks,
data
going
forward
in
terms
of
who's
receiving
the
vaccine
sort
of
the
sites
and
who
is
getting
vaccinated.
P
So
I'm
going
to
stop
here
and
just
ask
dr
pan,
the
co-chair
of
the
cvac
to
make
any
comments
at
this
point.
E
Great
thank
you
very
much,
dr
schechter
and
dr
brooks,
and
thank
you
again
for
your
leadership
of
the
drafting
guidelines.
Work
group.
E
So,
as
you
can
see
sort
of
from
this
important
conversation,
I
think
we've
heard
from
many
of
you
and
again
from
our
drafting
guidelines,
work,
group
and
implementers,
and
you
know,
essentially,
we
are
taking
this
incredibly
seriously,
and
this
is
this
is
the
next
priority
group
I
wanted
to
highlight
some
languages,
that's
discussed,
but
I
think
we're
still
sort
of
you
know
as
as
mentioned
here
in
one
of
these
bullets.
E
I
think
all
of
these
conditions
and
disabilities
need
further
definition
and
really
importantly,
methods
to
really
do
this
in
a
an
equitable
way,
and
this
is
all
part
of
again
access
and
equity.
An
inclusion
of
this
is,
you
know,
not
only
sort
of
the
higher
risk
for
hospitalization
and
deaths,
but
really
thinking
about
again
equity
and
access.
E
So
some
of
the
ways
where
we've
talked
about
defining
a
developmental
or
high-risk
disability
would
be
if
an
individual
is
not
only
likely
to
develop
severe
life-threatening
illness
or
death
from
covenant
infection,
but
that
acquiring
covet
19
would
limit
the
individual's
ability
to
receive
ongoing
care
or
services
vital
to
their
well-being
and
survival,
and
that
providing
adequate
and
timely
coveted
care
would
be
particularly
challenging
as
a
result
of
the
individual's
disability.
So
those
were
some
things
that
are
being
discussed
as
well,
and
I
think
really.
E
The
outcome
is
that
the
secretary
gallery
and
secretary
richardson
have
directed
us
to
have
a
group,
a
vaccine
implementation
group
to
really
take
a
deeper
dive
into
these
really
important
issues
and
hearing
also
about
how
again
to
make
sure
this
can
be
implemented.
Because
we've
heard
equally,
as
you
just
saw
some
concerns
about
how
to
operationalize
this.
So
it
is
sort
of
the
next
priority
to
do
and
there's
going
to
be
a
again,
a
group
convened
and
vaccine
implementation
group
around
these
individuals
helping
to
further
define
this
group.
E
E
What
level
is
that
and
how
do
you
define
severe
diabetes
mellitus,
so
this
is
going
to
be
a
planning
process,
though,
and
where
we
can
create
a
network
of
providers
to
ensure
that
we
are
addressing
accessibility
for
people
with
pre-existing
conditions
so
of
all
disabilities,
and
we
really
want
to
get
this
right
so
again,
I
think
what
we've
been
learning
over
the
first
few
weeks
of
this
vaccination
campaign
and
as
you've
been
hearing
about
over
the
course
of
this
meeting
as
well.
E
Is
we
want
to
plan
well
and
get
it
right
to
operationalize
it?
So
that's
what
this
this
meeting
will
will
do,
and
it
will
start
this
friday
and
actually,
the
kim
mccoy
wade,
the
director
of
the
department
of
aging,
will
be
helping
to
lead
that
group
and
wanted
to
briefly
introduce
her
to
all
of
you
to
say
a
few
words
about
that
group
that
will
be
convened
this
friday.
Q
Thank
you,
dr
pawn.
I
will
really
be
a
few
words
because
first
of
all,
just
want
to
thank
all
of
you
and
all
of
the
committee's
work
that
really
teased
that
up
I'll
be
joined
by
director
nancy
bargeman
from
dds
and
director
eragon
from
cdph,
in
supporting
our
secretary
secretary
galley
and
secretary
richardson
from
gov
ops
in
this
work
group,
and
I
want
to
thank
the
representatives
from
disability,
community,
the
aging
community
and
other
stakeholders,
the
medical
community
and
labor,
who
will
be
joining
us
in
that
group.
Q
So
we
will
begin
our
work
at
the
end
of
this
week
and
address
recommendations
and
advice
on
the
who,
the
when
the,
how
and
the
where
really
get
to
brass
tacks
on
how
to
operationalize
equity
and
really
make
it
real
so
more
to
come.
And
thank
you
for
those
about
those
of
you
who
are
willing
to
roll
up
your
sleeps
and
get
to
work
with
us.
E
E
That
again
we
want
to
make
sure
we're
attending
to
to
this
group
for
sure,
and
then
then
there
still
is
the
intent
to
move
to
an
age-based
framework,
but
we
want
to
get
through
sort
of
where
we
are
and
then
do
the
planning
of
those
next
steps
and
then
be
shifting
and
pivoting
to
the
age-based
framework
that
we've
we've
discussed,
and
we
do
you
know,
as
we
are
hearing
more
again
about
supply,
we're
hoping
to
really
work
towards
mapping
out
when
we
think
we
can
get
to
each
of
the
next
steps
and
being
able
to
do
that
in
the
near
future.
P
E
Great,
thank
you
so
much
dr
brooks
all
right
with
that.
I
think
we
can
take
any
initial
questions
and
let
me
start
with
that
bobby.
Let
you
facilitate.
A
I
thank
you
erica.
We
are
running
up
against
the
clock,
so
we're
only
gonna
have
time
for
a
couple
of
questions
in
this
section,
so
we're
gonna
start
with
aaron
and
then
go
to
ron
fong
and
then
we'll
see
where
we
are,
but
just
know
that
we
really
appreciate
your
comments
in
the
chat.
If
you
don't
have
a
chance
to
speak
verbally
aaron,
please
introduce
yourself.
R
Hello,
everybody
aaron
carruthers
from
the
state
council
on
developmental
disabilities,
really
want
to
acknowledge
and
think
the
amount
of
progress
that's
been
made
on
this
issue.
That's
that's
been
released
during
this
call
surgeon,
general
burke
harris.
We
want
to
thank
you
for
leading
off
the
conversation
at
the
beginning
of
the
meeting
by
acknowledging
and
stating
that
disability
is
part
of
the
state's
equity
framework.
Dr
pond,
thank
you
for
coming
to
the
state
council's
meeting
last
week
to
state
the
same
and
dr
brooks
and
dr
schecker.
R
Thank
you
for
the
presentation
of
of
how
to
take
the
science
and
thread
the
needle
for
a
solution
forward.
There's
a
lot
clearly
a
lot
of
work
and
dedication
and
commitment
to
this
and
in
responsiveness
to
what
we've
been
raising
on
these
calls
in
these
meetings.
So
thank
you
for
that.
The
proposal
that
was
presented
it's,
I
think
it
is
the
best
attempt
to
thread
the
needle
based
on
the
science.
It's
very
complicated.
It's
very
confusing
I
think
it'd
be
very
difficult
to
implement.
R
So
one
suggestion
off
the
top
is,
I
really
think
developmental
disabilities
needs
to
be
named
in
the
list
among
people
with
with
disabilities
and
those
severely
impacted
by
covid,
but
this
developmental
disability
specifically
needs
to
be
named,
but
I'm
looking
forward
to
the
work
groups
where
we
can
roll
up
our
sleeves
and
figure
out
how
to
make
this
really
functional.
So
thank
you.
S
Thank
you
bobby
ron,
fong,
president
of
the
yield,
california
groceries
association.
Thank
you
to
dr
brooks
for
reaffirming
tier
1b.
There's
some
confusion
as
to
where
65
and
older
lie,
whether
they're
a
priority
or
not,
and
I
remember
that
we
had
a
whole
meeting
about
65
and
older
not
being
prioritized
over
tier
1b,
and
that
seems
to
be
reaffirmed.
S
Yet
we
are
seeing
counties
in
particular
sacramento,
solano
and
placer
that
are
prioritizing
65
and
older
ahead
of
tier
1b,
essential
workers,
and
then
they
are
also
prioritizing
the
essential
workers
groups
over
another
grocer's
being
last.
So
I
wanted
to
see
if
anybody
had
any
clarification
on
how
counties
are
able
to
do
that
or
if
they
should
be
able
to
do
that.
E
I
can
take
a
stab
at
a
response
and
you
know
I
again
hear
and
understand
your
concerns
and
I
think
just
reflecting
back
on
my
opening
comments.
I
think
you
know
we
are
in
a
transition
phase
right
now
and
just
back
to
the
numbers,
which
was
part
of
my
other
role.
E
We
have
around
three
million,
or
so
that
are
eligible
in
phase
1a
and
the
current
phase
1b
tier
1,
including
65
and
older,
and
those
three
sectors
and
groceries
are
included
in
the
food
and
agricultural
sector
is
approximately
eight
and
a
half
million.
I
believe
so
that's
11.5
million
people
that
are
eligible,
which
means
we
need
23
million
doses.
I
think
I
explained
to
you:
we've
received
about
6
million
doses,
so
we
are
in
this
transition
phase,
where
we
have
said
that
you
know
that
in
tier
1
phase
1b
that
those
groups
are
equal.
E
On
the
other
hand,
when
you
get
again,
it
all
comes
down
to
the
devils
and
the
details.
If
you're
trying
to
operationalize
that
and
trying
to
again
be
you
know
as
efficient
as
possible,
you
know,
I
think
different
counties
have
there's
two
things
that
I
think
are
occurring.
One
is
that
they
had
plans
in
place
before
sort
of
we
at
the
state
pivoted
our
direction
and
two
again,
I
think,
really
trying
to
operationalize.
This
is
extremely
difficult
and
again
extremely
challenging
decisions
that
people
are
making.
E
But
again
you
know,
that's
that's
where
we
are.
I
think
it's
going
to
take
us
a
bit
of
time
to
get
through
that
eight
and
a
half
million
people.
You
know
and
and
we've
seen
some
early
data
as
well
around
hesitancy.
So
we
want
to
work
with
all
of
you
on
that
part
as
well
to
improve
our
our
uptake
in
the
various
communities.
I
do
think
as
we
look
forward,
we
will
likely
be
you.
N
E
We
I'm
I'm,
I
think,
we're
thinking
about
this
as
like
a
rolling
eligibility,
so
we're
not
going
to
absolutely
get
through
each
phase
before
we
start
the
next
group,
but
we
also
want
to
you
know,
make
a
good
dent
in
it.
So
I
think
that
is
what
you
are
seeing.
There
is
some
variability,
but
that
is
you
know.
On
the
other
hand,
too,
I
think
that's
the
other
direction,
we're
going
as
far
as
more
centralization,
more
equivalency
across
the
whole
state
and
and
that's
the
challenge
we're
in
in
this
transition
phase.
C
C
I
can
tell
you
that,
as
a
person
with
a
disability
who
has
multiple
underlying
health
conditions
that
would
qualify
me,
I
don't
feel
confident
that
even
the
best
primary
care
doctors
would
actually
be
able
to
give
me
the
documentation
that
I
need
to
get
qualified
for
a
vaccine.
So
that's
very
concerning
number
one
number
two.
I
know
that
we've
been
really
pushing
for
both
regional
center
clients
and
for
those
that
have
hcvs
waivers,
I'm
curious
to
know
why
only
the
idd
population
was
taken
into
account.
C
Three,
I
really
do
feel
like
the
standards
that
were
put
in
place
were
not
recommendations
that
we've.
C
Go
yeah.
Thank
you.
Sorry,
it's
just
usb
mic
and
three.
I
don't
think
that
the
recommendations
posed
have
are
in
line
with
what
we've
been
suggesting.
C
And
fourth,
I
really
really
want
to
emphasize
choice
for
people
with
disabilities.
C
I
want
to
have
a
choice
if
I'm
qualified
for
a
vaccine
to
go
to
a
site
that
is
going
to
be
best
and
easiest
for
me
to
get
to
and
knowing
that
my
doctor's
office
can
be
very
hard
to
get
an
appointment
in
if
it's
faster.
For
me
to
go
to
another
site
by
public
health,
I
want
to
be
able
to
go
to
that
site.
Thank
you.
A
Thanks
christina
dr
pond,
I
think
you
wanted
to
make
a
comment
and
then
we're
going
to
have
to
move
on
to
our
next
topic.
So
I
encourage
everyone
that
wanted
to
speak
verbally
to
put
their
comment
in
the
chat.
E
Be
really
quick,
I
did
see
it
and
I
know
it's
been
a
theme
and
one
of
the
recommendations
so
we're
working
on
how
to
address
high-risk,
concrete
settings
so
including
our
incarcerated
settings,
homeless,
shelters,
other
high-risk,
congregate
settings,
so
I
think
it'll
be
part
of
our
equity
framework
as
we
work
with
the
tpa
and
think
about
incentives
and
other
things,
but
it's
still
in
the
works.
So
we
will
return
back
with
more
detail
to
you.
The
next
time.
B
Thank
you,
and
so,
and
now
we
want
to
move
forward
to
how
we're
using
equity
as
we
move
forward
and
if
we
could
go
ahead
and
bring
up
the
next
slide.
B
So
if
you
all
will
recall
at
our
last
meeting,
we
talked
about-
and
I
presented
information
about
what
it
would
look
like
to
for
the
state
to
utilize
a
categorized
prioritization
system
that
included
a
database
tool
to
calculate
how
we
distribute
the
a
scarce
resource
equitably.
Next
slide.
B
Please-
and
you
know,
as
we've
heard
on
this
call-
and
it's
been
reiterated-
is
it's
it's
critically
important
as
we
move
forward
to
address
both
equity
and
simplicity,
so
that
we
can
move
forward
in
in
getting
vaccines
to
the
communities
that
need
them,
and
so
one
of
the
tools
to
be
able
to
do.
That
is
a
categorized
priority
system.
B
It's
currently
being
used
in
massachusetts,
tennessee,
new
hampshire
and,
I
believe
in
consideration
in
rhode,
island
and
the
example
that
I
shared
at
the
last
meeting
that
I
want
to
reorient
you
all
to
is
the
example
of
potentially
having
80
of
vaccine
supply
being
allocated
according
to
the
current
methodology
and
20
of
the
vaccine,
supply
that
could
be
allocated
to
counties
or
regions
that
has
the
lowest
hpi
quartile
zip
codes,
and
that
can
be
zip
codes.
It
can
be
census
tracts.
B
There
are
different
ways
that
that
determination
can
be
made
next
slide,
please,
and
so,
if
you'll
remember
just
to
refresh.
This
is
a
slide
that
we
shared
last
time
about
the
categorized
priority
system
around
how
that
might
work,
and
we
got
lots
of
questions
about
it.
So,
if
you'll
move
to
the
next
slide,
please
what
we
try
to
do
today
is
just
to
simplify
a
little
bit
to
have
a
clearer
sense
of
how
the
how
we
can
use
how
we
can
use
equity
in
our
vaccine
allocation
right.
B
If
you
will
see
you
know
a
hundred
percent
of
vaccine
doses
or
that
is
going
to
a
county
or
a
region,
if
you
break
that
into
80
20
and
allocate
the
80
as
it
typically
would
be,
allocated
right
and
so
20
would
go
to
the
first
quartile
highest
hpi
quartile
20
would
go
to
the
second
highest
hpa,
quartile
20
to
the
third
highest
hpa,
quartile
and
20
to
the
lowest
hpi
quartile,
and
then
take
that
remaining
20
and
allocate
that
to
the
lowest
hpi
quartile,
which
would
be
our
most
vulnerable
communities.
B
What
this
shows
is
that
the
aggregate
distribution
to
the
lowest
hpi
quartile
would
end
up
being
40
and
what
the
goal
there
is
try
to
look
at
the
data
around.
Where
are
we
seeing
the
the
greatest
number
of
cases
and
the
greatest
number
of
deaths
and
to
really
try
to
use
this
equity
framework
of
understanding?
B
That
of
how
we
bring
doses,
a
proportionate
amount
of
doses
to
the
communities
that
are
most
vulnerable
and
who
are
experiencing
the
greatest
impact
as
a
result
of
covert
19.
next
slide?
Please,
and
so,
when
we
look
at
our
tools
to
address
equity,
we
want
to
highlight
one
tool
is
allocation
and
a
categorized
priority
system
is
one
of
the
tools
that
we're
looking
at
to
be
able
to
do
that.
B
We
heard
about
you'll,
hear
more
later
in
this
meeting
about
earned
and
paid
media
that
is
powered
by
research,
about
how
we
reach
vulnerable
communities
and
how
we
ensure
that
the
the
we're
addressing
reasons
why
certain
communities
don't
have
as
much
vaccine
confidence
as
others.
B
We
talked
about
partnering
with
community-based
organizations,
both
in
outreach
and
communication,
but
also,
as
we
talked
about
as
well
to
a
as
we
heard
from
from
marta
greene
earlier
in
this
conversation
today,
really
to
help
to
ensure
that
folks
like
getting
folks
to
their
their
appointments
to
actually
get
their
immunization
so
really
in
the
implementation
and
some
of
the
tools
that
we
have
that
we're
seeking
to
deploy
around.
B
That
include,
as
we
talked
about
incentives,
support
accountability,
pay
for
performance
right
and
when
we're
talking
about
you,
know,
vaccine
administration
and
our
low
hpi
communities
to
our
vulnerable
communities
in
pop-up,
clinics,
transportation,
services
and
in-home
services,
and
there
was
a
question
previously
in
the
chat
around.
Why
would
we
incentivize?
B
B
It's
a
recognition
of
the
historic
and
structural
barriers
that
exist
that
make
it
more
difficult
for
these
communities
to
have
the
same
access
to
vaccine,
and
so
we
do
have
to
incentivize
and
do
pay
for
performance
if
we
want
to
get
equivalent
outcomes
in
vulnerable
communities
that
face
greater
obstacles
and
part
of
the
reason
why
you
know
we've
looked
at
the
healthy
places
index
is
that
the
healthy
places
index
is
targeted.
B
It's
an
index
that
looks
at
what
are
the
resources
that
com
communities
need
to
keep
themselves
healthy
access
to
transportation,
access
to
education,
how
many
health
care
centers
are
located
per
capita
in
a
community
and
unfortunately,
because
of
the
the
history
of
racism
and
discrimination
in
the
united
states.
B
What
we
see
is
that
those
community
resources
are
not
evenly
allocated,
and
that
is
part
of
the
reason
that
gives
rise
to
the
differences
that
we
see
in
in
health
outcomes
in
vaccination
rates,
and
if
we
want
to
acknowledge
the
structural
factors
that
make
it
difficult
for
vulnerable
communities
to
get
equivalent
to
achieve
equivalent
outcomes.
B
So
if
we
go
to
the
next
slide,
I
just
want
to
refresh
the
slide
that
we
saw
presented
by
marta
green
around.
How
will
california
track
and
achieve
equitable
vaccine
delivery
right
and
highlight
that
we,
you
know
we
do
pay
for
performance
in
lots
of
different
fields
right.
We
do
pay
for
performance
across
industries,
we're
doing
pay
for
performance
on
equity
right,
so
we're
doing
pay
for
performance
for
vaccinating
individuals
in
our
lowest
hpi,
quartile,
census,
tracts
or
or
zip
codes.
We're
still
operationalizing
that
piece
we're
giving.
B
We
intend
to
give
payments
to
providers
for
bringing
vaccines
to
communities
of
color
payments,
for
targeted
outreach
and
engagement
for
for
reaching
hard
to
reach
communities
and
enhanced
payments
to
facilitate
accessibility
with
you
know
the
evening,
hours,
translation,
physical
services
etc,
and
that
is
really
these
are
some
of
the
key
tools
that
california
is
deploying
to
bring
equity
to
the
center
of
the
work
that
we
are
doing
and
so
I'll
pause
there
so
that
we
can
for
any
questions.
A
T
Yeah,
thank
you
jake
snow.
I'm
an
attorney
at
the
aclu
of
northern
california
and
doctor
burst
berkera
said
that
that's
still
being
operationalized
and
so
just
request
an
answer
on
that.
I
see
that
there's
a
little
bit
of
inconsistency
in
the
slides
with
respect
to
whether
the
hpi
will
be
calculated
by
census,
tract
or
zip
code
and
and
wanted
to
know
that
details.
So
thank
you
very
much.
U
I
I
do
have
a
question,
I'm
wondering
if
we
can
link
the
helpful
remarks
that
dr
burke
harris
just
provided
in
the
prior
discussion,
which
is,
can
you
help
me
understand
how
the
current
status
of
phase
one
be
tier,
one
which
is
doctor
conan,
explain,
and
I
think
we
all
understand
there
are
more
people
than
current
vaccines.
U
So
there's
you
know
challenges
in
terms
of
how
to
operationalize
that
and
how
will
equity
be
incorporated
into
that
part
of
the
decision
making
and
rollout
and
operationalizing
of
phase
1b
tier
one.
I
think,
just
as
an
example,
we
saw
some
in
the
chat
box
around
farmworkers
and
sort
of
how
that's
impacting,
from
my
perspective,
thinking
about
child
care
workers.
We
know
there
are
significant
issues
there
is
women
of
color
and
that
it's
affecting
other
women
workers
of
color
who
are
not
able
to
access
child
care
necessarily.
B
I'm
happy
to
comment
on
that.
I
also
dr
pond.
I
I
know
you
it.
You
look
like
you
had
something
that
you
were
going
to
say
as
well,
but
let
me
go
ahead
and
respond
to
this
question
first.
So
a
as
I
think,
we've
talked
about
in
previous
meetings,
but
I
want
to
reiterate
when
the
drafting
guidelines
work,
group
first
developed
a
a
a
framework
that
was
based
on
in
part
on
age
and
in
part
on
sector.
B
Part
of
the
reason
why
they
had
this
framework
was
as
one
way
to
operationalize,
equity,
right
and
so
having
that
sector
framework,
and
particularly
when
we
look
at
the
prioritization
of,
for
example,
farm
workers,
child
care
workers.
That
was
one
way
of
of
doing
that
and
as
we
as
we
as
a
state
recognize
that
we
needed
to
move
from
an
a
sector
and
age-based
framework
to
a
more
aid
to
a
more
strict
age-focused
framework.
B
We,
the
determination,
which
you
all
heard,
announced
in
in
previous
weeks,
was
that
we're
going
to
complete
phase
we're
going
to
complete
tier
one
of
phase
1b,
and
then
we
will
move
from
there
to
an
age-based
framework
and-
and
so
that
is
what
the
state
of
california
is
doing,
part
of
the
consideration
of
completing
tier
one
of
phase
1b
was
it
included
this
consideration
of
equity
and
this
recognition
number
one.
B
There
were
many
counties
that
had
already
begun
implementing
tier
one
of
phase
one
b
and
but
really
that
consideration
was
a
part
of
it
and
then,
in
addition,
this
recognition
of
of
as
we
were,
moving
to
a
a
a
more
age-based
system,
recognizing
that
the
allocation
of
vaccine
to
our
more
vulnerable
communities
would
be
an
important
aspect
of
being
able
to
address
equity
while
moving
to
a
more
age-based
framework.
B
So
in
in
response
to
your
specific
question
around
how
was
equity
considered
equity
was
very
much
considered
in
thinking
about,
for
example,
we
know
among
our
farm
workers
we
have
among
the
highest
rates
that
that
we're
seeing,
especially
in
the
central
valley
when
we
look
at
cases
hospitalizations
and
deaths.
We
know
that
our
latino
population
is
disproportionately
impacted
in
california
and
when
we
look
among
our
farm
workers
right,
we
see
that
you
know
that
was
it
especially
in
the
central
valley.
These
are.
B
This
is
where
we've
been
seeing
very
high
case
rates,
and
so
that
was
part
of
the
consideration
about
main
completing
that
tier,
before
moving
to
an
age-based
system.
Does.
U
Thank
you,
I
mean,
I
think.
Yes,
I
think
that
I
really
appreciate
all
the
thought
and
the
centering
of
equity
that
went
into
the
creation
of
when
I
candidly,
I
think,
we're
all
wrestling
with
the
reality
that
even
within
phase
1b
tier
1,
we
have
more
people
than
we
have
vaccine
and
that
at
least
at
the
local
level,
as
it's
rolling
out
and
operationalizing,
I
think
we're
not
quite
seeing
yet
the
past
to
reach
some
of
the
groups.
We've
all
agreed
from
an
equity
perspective.
It's
really
important
to
reach
sooner
rather
than
later.
U
A
J
Yes,
thank
you
and
I'll
be
quick,
and
I
first
want
to
say
thank
you,
dr
burke,
harris
for
sort
of
laying
out
the
history
of
structural
racism
in
our
communities
and
in
this
country.
I
think
it's
just
really
helpful
to
hear
that
framing
over
and
over
again,
because
it's
so
important
that
we
understand
that
in
this
conversation,
my
question
is
really,
if
you
can
help
us
understand
sort
of
moving
from
what
we
were
talking
about
before,
which
was
a
minimum
allocation
of
doses
to
our
lowest
quartile
hpi,
zip
codes.
J
B
So
kieran
I
want
to
bobby,
can
you
can
you
put
up
my
last
slide
really
quickly?
If
I
understand
your
question,
it
sounds
like:
why
are
we
moving
away
from
greater
allocation
to
no.
B
Bobby,
can
you
go
back
to
thank
you
for
clarifying
your
question?
Can
you
go
back
to
the
previous
slide
before
this
yeah?
So
when
I
say
tools
to
address
equity,
what
I
mean
is
alec.
So
when
we
have
a
third
party
administrator,
the
state
allocates
where
the
doses
go
through
the
third
party
administrator.
B
So
when
we're
talking
about
having
using
the
data
to
say
these
communities
have
higher
rates
and
higher
deaths,
and
we
know
that
part
of
that
is
because
of
the
history
of
structural
racism
and
the
obstacles
that
have
been
put
in
and
third
party
administrator.
You
need
to
allocate
for
whatever
the
percentage
that
we
end
up
with
x
percent
of
doses
to
that
lowest,
quartile
hpi.
B
That's
one
part
of
the
contract
that
we're
going
to
hold
them
accountable
to
the
next
part.
You
know
we're
doing
the
outreach
you're
going
to
hear
about
the
urban
paid
media
we're
going
to
hear
about
and
when
we
say
partnering
with
community
based
organizations,
that's
another
part
of
the
contract
that
we're
going
to
hold
them
accountable
to
this
is
not
a
nice
to
have.
This
is
a
must-have
when
we
say
incentives
for
supporting
and
pay
for
performance.
B
What
we're
seeing
is-
and
this
is
I
want
to
be
clear-
this
is
really
important
when
you
remember
marta
said
at
the
beginning
that
this
is
it's
a
cost
basis,
so
the
third
party
administrator
they
get
the
cost
for
doing
it,
but
they
don't
get
to
make
money
off
of
it.
The
pay
for
performance
is
not
from
the
state
of
california
to
the
third
party
administrator
right.
The
paper
performance
is
from
the
third
party
administrator
to
our
vaccinators
on
the
ground
right
to.
B
Targets
you
need
to
we're
going
to
incentivize
you
to
vaccinate
folks,
and
so
this
is
this.
Is
these
are
ands?
These
are
not
ores.
This
is
allocation.
Yeah,
we're
gonna,
we're
we're
gonna.
Do
that
outreach?
We're
gonna.
Do
that
media,
we're
doing
that
paper
performance,
we're
gonna,
do
that
all
of
these
are
necessary
because
achieving
equity.
That's
not
something!
That's
easy,
it's
very,
very,
very
hard
to
do.
B
B
And
with
that,
it
is
505
it's
time
for
a
break,
very
grateful
for
you
all.
We
will
reconvene
at
I'm,
I'm
gonna,
I'm
gonna
five
minutes
five
minutes.
Five,
ten
we'll
be
back
at
5
10.
B
Everyone
to
get
some
water
practice,
some
self-care
stand
up
if
you're,
able
and
otherwise
stretch
out
in
anything,
that'll
get
your
circulation.
A
A
B
B
Thank
you
bobby
and
so
now
moving
forward,
we're
going
to
talk
a
little
bit
more
about
community
engagement,
equity
and
vaccine
acceptability
and
continue
that
discussion.
B
I'm
pleased
to
re-introduce
maricela
rodriguez
from
the
office
of
the
governor
as
well
as
marcela
ruiz
from
the
california
department
of
social
services
and
martha
dominguez,
as
well
as
dr
arlene
brown.
I'm
sorry,
dr
martha
dominguez,
as
well
as
dr
arlene
brown,
maricela,.
A
V
Okay-
and
I
may
be
talking
really
fast,
because
I'm
running
against
the
clock
with
my
son
in
the
background
who
may
need
help
in
a
second
so
just
appreciate
the
conversation
on
equity
and
the
work
that
we're
doing
as
we
move
forward.
If
we
can
go
into
the
next
slide.
What
I
wanted
to
do
is
just
give
a
quick
overview
of
what
you're
going
to
expect
out
of
this
presentation.
V
One
is
that,
as
the
state
ramps
up
our
efforts
on
vaccination,
we
one
want
to
give
you
a
quick
snapshot
on
highlights
on
just
some
of
the
work
that
we've
been
doing
so
far
and
then
some
of
the
an
update
on
our
community
engagement.
Since
we
know
that
working
with
trusted
messengers
is
going
to
be
key,
giving
you
a
quick
update
on
that
and
then
as
we
ramp
up.
V
We
also
want
to
ensure
that
we're
continuing
to
address
issues
of
hesitancy
and
really
creating
content
within
a
an
approach
that
is
about
cultural
humility
and
so
we're
gonna,
give
you
some
research
insights
on
that
and
we'll
go
ahead
and
get
started
so
the
next
slide.
V
V
V
We
have
programmatic,
impede
social,
so
we're
doing
things
like
not
just
the
social
media
platforms,
but
things
that
you
see
like
pre-roll
on
on
websites
and
things
like
that
and
again.
This
is
just
a
quick
snapshot
on
our
on
our
digital
and
social
work.
V
Our
approach
right
now
is
to
really
be
nimble
and
to
be
as
quick
as
possible
and
reaching
as
many
people
as
possible
with
those
key
messages
that
we've
been
talking
about,
that
this
group
has
raised
in
the
past
about
ensuring
that
people
know
inform
that
have
information
on
safety
and
effectiveness,
about
information
being
protected
and
how
they
are
free
and
we're
going
to
continue
to
build
upon
that
messaging
as
we
move
forward.
V
And
then
just
really
quickly,
we
had
mentioned
before
that.
We,
you
know
part
of
our
earned
media
efforts,
included
not
just
we're
almost
at
a
daily
cadence
right
now
and
doing
earned
media
appreciation
to
some
of
the
folks,
including
our
surgeon,
general
and
dr
aragon,
dr
pan,
who
have
been
with
us
in
in
getting
almost
a
daily
cadence
of
rapid
response
out
there
to
help
share
information
in
real
time
with
ethnic
media
and
general
media.
V
So
we
did
three
different
media
briefings
over
the
last
week,
or
so
that
generated
engagement
with
79
different
outlets
and
90
pieces
of
coverage
to
date,
and
we
hope
that
that
will
grow
and
then
we're
going
to
continue
to
do
them
as
we
move
forward
and
both
in
february
and
march,
bringing
on
a
partner
nuna
who's
going
to
help
us
with
our
tribal
communities.
So
just
wanted
to
give
you
a
snapshot
that
you
know
how
we
did
this
in
partnership
with
other
folks
and
trying
to
share
information.
V
That's
you
know
is
important
to
share
that
can't
be
done
in
the
30-second
psa.
That's
where
earned
media
really
comes
into
play,
and
we
want
to
make
sure
that
we're
reaching
people
with
the
information
that
they
need
next
slide
and
the
next
site
is
just
going
to
give
you
some
samples
of
some
of
the
stories
that
have
come
out
of
our
earned
media
efforts
next
slide
and
then
wanted
to
note
that
we
have
some
new
graphics
on
our
partner
toolkit
site.
Both
one
is
on
my
turn.
V
That
includes
the
call
center
number,
because
we
know
that
folks
sometimes
wanna,
it's
it's
better
for
them
to
have
in-person
assistance
or
some
someone
who
can
help
them
in
person
over
the
phone.
So
we
do
include
the
phone
number
there.
So
there
is
a
connection
between
the
call
center
and
my
turn
have
these
in
english
and
spanish
now
on
our
toolkit
site
and
then
a
web
button,
so
folks
can
continue
to
share
the
availability
of
the
information
that
we
have
on
our
cobit
website.
V
So
those
are
now
in
our
toolkit
website
and
we're
going
to
continue
to
create
content
continue
to
translate.
But
just
wanted
to
show
you
a
sample
of
what
we
have
so
far
since
since
the
last
meeting
next
slide
and
then
one
of
the
samples
that
I
wanted
to
mention.
V
As
we
move
in
as
we're
now
in
february
and
have
black
history
month,
we
are
going
to
be
highlighting
what
we're
calling
covenanting
heroes,
folks
that
are
on
the
ground
on
the
front
lines,
with
supporting
efforts
to
mitigate
the
spread,
to
get
information
out
about
vaccines
and
those
key
messages.
V
V
We're
gonna
have
over
250
different
radio
spots,
but
it
will
also
be
amplified
through
print
social
and
earned
media
efforts
and
again
leveraging
black
history
month
to
really
reach
our
african-american
black
community,
with
key
messages
that
we're
continuing
to
to
learn
and
collect.
That
need
to
be
addressed
with
this
particular
population.
V
And
then
I
want
to
pass
it
over
to
marcelo
who
will
give
you
an
update
on
our
community
engagement
and
know
that
there
is
a
lot
more
work
now
happening
that
when
we
meet
again
we'll
be
able
to
showcase,
including
potentially
even
a
new
psa.
There's
a
lot
of
work,
that's
happening
now.
I'm
excited
to
bring
that
back
to
the
team,
to
showcase
and
do
a
little
bit
more
show
and
tell
but
wanted
to
keep
it
short,
because
we
have
a
lot
of
really
good
content
to
discuss
both
from
marcella
and
on
our
research.
W
I
wanted
to
provide
everybody
with
an
update
on
the
community
outreach
campaign
and
thank
you
again
for
inviting
us
into
this
space
now
for
for
the
second
time,
as
we
have
talked
about
in
the
last
couple
of
meetings,
cdss,
the
department
of
social
service
and
labor
workforce
development
agency,
we
are
jointly
administering
funding
to
support
outreach
to
disproportionately
impacted
populations
and
people
working
in
high
risk
industries,
and
we
will
be
contracting
with
about
150
organizations
statewide
to
conduct
that
outreach
next
slide.
Please.
W
What
I
would
like
to
do
today
is
to
provide
you
an
update
on
the
the
timeline
for
the
outreach
project
and
also
to
announce
the
second
partner
for
for
the
cdss
funding.
As
we
have
mentioned,
lwda
and
cdss,
we
are
both
working
through
the
center
at
sierra
health
to
administer
the
program.
The
center
is
administering
the
funding
statewide
on
behalf
of
lwda,
and
they
are
administering
the
funding
in
all
counties
except
ventura
orange
and
los
angeles
on
behalf
of
cdss.
W
Cdss
partner
for
ventura
orange,
in
los
angeles,
is
the
california
community
foundation
and
like
the
center
at
cr,
health
ccf
was
a
key
partner
for
the
state
on
census,
outreach
and
has
critical
partnerships
and
infrastructure
to
support
outreach
to
disproportionately
impacted
populations.
So
we
are
thrilled
to
have
them
on
board.
What
you
are
seeing
is
the
timeline
for
what
we
are
calling
the
two
cohorts,
the
first
one
being
the
cohort
with
the
center
at
sierra
health
and
the
second
cohort
being
the
california
community
foundation
cohort
cohort
one.
W
We
are
very
pleased
to
announce,
goes
live
tomorrow,
and
the
list
of
about
100
partners
will
be
publicly
announced.
Then
they
were
informed
on
january
29th
of
the
states
intended
to
fund
them.
We
are
working
through
some
of
the
logistics
to
finalize
the
the
announcement,
but
as
of
tomorrow,
that
will
be
public
over
the
next
few
weeks
and
starting
tomorrow
we
are
going
to
be
hosting
a
series
of
onboarding
sessions
while
finalizing
the
contracting
logistics
for
those
partners
who
will
begin
their
outreach
on
february
16th.
W
Cohort
2,
which
is
the
ccf
cohort,
is
currently
in
the
selection
process.
Ccf
released
their
invitations
on
january
29th
and
they
are
expecting
to
have
partners
selected
by
february
11th,
and
we
are
currently
determining
the
dates
for
for
the
onboarding,
and
we
are
anticipating
that
outreach
will
begin
in
march
next
slide.
Please.
W
So
we
have
presented
some
of
the
following
information
at
a
high
level
in
in
in
the
past.
We
wanted
to
just
quickly
circle
back
and
spend
some
time
walking
through
the
approach
and
especially
spend
spend
a
little
bit
of
time
talking
more
about
the
activities
that
we
are
going
to
be
funding,
as
we
have
shared
this
project
to
statewide
and
we
are
focused
on
disproportionately
impacted
populations.
W
Outreach
priorities
will
be
driven
by
data
about
covid
burden,
or
in
other
words,
where
we
see
the
highest
rates
of
covid
and
also
by
the
healthy
places,
index
and
other
equity
indices.
That
shows
us
the
communities
experiencing
the
worst
health
outcomes.
W
The
partners
are
going
to
have
access
to
data
maps
and
tools
to
help
target
their
research.
We
are
prioritizing
high
quality
or
what
we
are
calling
interactive
engagement,
which
includes
training
in
person
or
online
phone
banking,
door-to-door
activities,
canvassing
and
bidirectional
texts
and
emails.
I
just
wanted
to
to
explain
that.
W
We
will
support
one-way
outreach,
such
as
social
media
and
traditional
media,
but
that
will
will
not
be
the
priority
for
it
for
this
particular
project.
Ultimately,
the
goal
is
to
direct
people
toward
the
vaccine
toward
process
availa
processes
that
are
available
to
them
to
enforce
their
labor
rights
and
and
other
economic
supports.
W
We
have
received
some
feedback
from
cbo
partners
concerned
that
we
may
be
imposing
very
strict
activity
requirements,
and
I
just
want
to
share
with
you
that
we
certainly
are
structuring
this
to
achieve
outreach
goals
and
want
to
evaluate
the
effectiveness
of
the
outreach
efforts,
and
so
we
are
asking
for
plans
and
reporting,
but
we
certainly
understand
that
organizations
may
have
to
shift
our
strategies
both
to
respond
to
conditions
on
the
ground
and
to
adapt
to
what
we
are
jointly
learning
about
effective
strategies.
So
there
will
be
room.
W
The
labor
outreach
will
focus
on
the
dissemination
of
information
related
to
workers
rights
with
a
particular
focus
on
industries
and
in
which
workers
may
experience
greater
risk
of
contracting
covid,
and
you
can
see
the
list
for
yourself
that
includes
agriculture.
There's
been
a
lot
of
conversation
about
farm
workers,
so
farm
workers
are
one
of
the
is
one
of
the
populations
that
will
be
targeted
through
through
this
outreach,
along
with
workers
and
the
other
industries
and
sectors
that
are
listed
on
the
slide.
W
The
cbo
partners
will
receive
training
and
material
to
support
the
labor
rights
and
the
specific
sector
outreach.
And,
finally,
what
I
will
lift
up
is
another
question
or
inquiry
we've
received
from
from
from
community-based
organizations
and
questions
about
the
collateral
and
the
outreach
material
that
will
be
available
for
outreach.
W
We
are
working
with
vendors
and
resource
researchers
to
inform
the
content
development,
but
we'll
also
want
to
emphasize
that
the
experience
and
perspective
of
the
cbo
and
philanthropic
partners
that
we're
working
with
is
critical
and
will
absolutely
want
to
collaborate
with
our
cbo
partners
to
develop
assets
and
collateral
as
this
project
unfolds.
W
W
We
have
spoken
and
met
with
a
with
a
number
of
you
over
the
last
couple
of
weeks
and
really
appreciate
you
sharing
your
concerns
and
your
perspectives
and
in
your
ideas,
and
I-
and
we
are
always
grateful
for
the
feedback
and
happy
to
adapt
the
program
where
we
can
and
how
we
can
to
more
effectively
partner
and
and
achieve
our
common
goals
of
ensuring
that
disproportionately
impacted
populations
are
able
to
get
to
the
vaccine,
get
to
the
resources
they
need
or
enforce
their
labor
rights.
And
so
I
will
hand
it
over
to
martha.
Thank.
F
You
you
marcella,
I'm
gonna
be
talking
through
my
phone
and
hopefully
you
can
hear
me.
Okay
bobby
sounds
like
yeah.
You
can
yes.
F
You
bobby
we
can
get
to
the
next
slide.
F
Next
slide,
please,
I
think,
but
I
spoke
to
you
guys
about
four
weeks
ago,
when
I
joined
the
I
joined
bach,
the
california
department
of
public
health
team.
We
told
you
that
we
were
working
on
onboarding,
a
media
agency,
so
I
wanted
to
give
you
guys
an
update.
We
have
found
a
multicultural,
integrated
media
agency
that
has
a
lot
of
specialized
capacities
and
experience.
F
They
are
duncan
and
shannon
they
are
bringing
a
slew
of
experts
that
will
help
us
ensure
that
we
have
a
multicultural
campaign
to
reach
all
californians.
We're
really
excited
about
this
team.
They're
very
experienced
very
creative,
so
we
wanted
to
give
you
that
update
next
slide.
I
also
wanted
to
kind
of
share
with
you
on
their
specific
goals.
They
have
a
big
task
ahead
of
them,
but
they
will
be
focusing
on
ensuring
to
have
a
strategic,
overarching
approach
for
public
health
messaging.
F
Their
strategic
approach
will
be
sequential.
They
will
be
connecting
educating
normalizing
and
activating
californians
with
very
creative
messaging
and
tactics.
This
is
just
an
overview
of
their
scope.
As
we
progress,
we
will
keep
you
informed
of
their
efforts,
but
we're
super
excited
to
have
duncan
and
shannon
and
the
slew
of
experts
that
they
bring
on
to
this
project
next
slide.
F
We
also
the
last
time
I
spoke
to
you.
I
talked
about
research.
We
have
a
very
robust
formative
research,
that's
really
informing
us
to
develop
deeper
understanding
of
the
barriers,
including
the
hesitancy
factors,
which
is
something
that
we're
all
very
concerned
and
want
to
address.
We
also
want
to
determine
motivators
for
adoption
and
also
want
to
examine
continuously
that
the
likelihood
of
a
californian
to
get
the
vaccine
and
and
overall,
we
want
to
make
sure
that
we
identify
the
best
communication
channel
to
deliver
these
messages.
F
In
order
for
us
to
do
that,
we
have
developed
what
we
call
four
different
stages
within
our
research.
We've
done
a
comprehensive
literature
review.
We've
done
some
stakeholder
interviews,
which
a
lot
of
you
participated,
we're
doing
generational
online
infographic
sessions,
online,
qualitative
and
quantitative
boards,
and
we
have
some
data
today
to
present
next
slide.
F
R
F
T
F
F
We
need
to
ensure
that
we
empower
messages
that
are
communicated
to
the
community
by
trusted
sources
within
each
community
that
will
resonate
best
for
each
segment,
someone
that
can
that
someone
that
can
be
related
to
them
or
relatable
to
them,
and
and
can
speak
some
of
the
subtle
nuances
on
how
impacting
it
may
be.
The
other
sort
of
theme
that
we
have
seen
is
the
dissemination
of
information
and
language
and
in
culture
this
is
going
to
be
really
critical
and
we're.
F
F
The
other
theme
that
we've
been
seeing
is
humanizing
live
disc
experiences,
testimonials
of
real
people
in
various
population
segments
who
can
share
their
experience
with
covet
19,
and
the
vaccine
like
why
they
got
it.
The
importance
how
it
will
impact
them
their
families.
F
F
The
other
thing
really
important
for
us
is
really
using
channels
to
reach
audiences,
where
they're
at
we
will
be
meeting
people
where
we're
at
from
our
air
game
and
also
through
the
resources
that
we'll
have
through
this
campaign.
We
have
to
share
messages
where
people
are
consuming
information
beyond
traditional
channels
and
based
on
population
segments
happening
tapping
into
localized
cbo's,
which
marcella
talked
about
that
local
news
media,
which
maricela
also
touched
upon
and
specialized,
especially
with
the
ethnic
media
outlets.
F
That
will
be
a
really
critical
tactic
that
we
will
be
leveraging
on
next
slide.
F
F
The
key
messaging
that
you
have
suggested
is
highlighting
the
safety
and
the
benefits
of
the
vaccine
to
integrate
the
concept
that
everyone
is
working
together
and
also
to
focus
on
how
the
vaccine
helps
family
and
community
and
to
address
the
side
effects
and
something
that
it's
not
new
to
all
of
us
is
that
we
know
that
there's
a
distress
in
government,
some
of
the
recommendations
that
you
gave
us
in
terms
of
trusted
sources
or
messengers,
or
influencers
are
doctors,
medical
professional,
religious
leaders,
promoters,
health,
navigators
and
trusted
community
members,
along
with
community
health
workers
and
cultural
centers,
family
members
and
caregivers,
along
with
legal
health
and
social
community
activists.
F
Some
additional
barriers
that
you
also
shared
with
us
in
terms
of
vaccine
acceptance
is,
you
know,
there's
a
fear
of
deportation,
especially
with
our
immigrant
community.
F
We
also
had
consumer
findings
with
diets
and
triads,
which
is
parents
and
their
children,
and
sometimes
it
was
just
a
parent
and
a
child.
We
did
things
across
california
and
one
of
the
things
that
they
told
us
that
the
clover
vaccine
was
a
tremendous
has
tremendous
emotion,
and
this
is
something
that
we're
seeing
as
a
common
theme.
There's
a
lot
of
anxiety,
fear,
frustration
and
anger
surrounding
this
topic,
which
causes
a
lot
of
the
cognitive
distancing,
there's
layers
of
confusion
that
feeds
into
that
hesitancy.
F
These
are
the
top
themes
and
topics
that
rose
up
when
we
talk
to
parents
and
their
children,
which
was
really
also
correlating
to
the
findings
that
we
had
with
the
stakeholders
and
the
literature
next
slide.
F
On
this
slide,
we
wanted
to
really
put
the
information
in
a
way
that
allows
us
to
really
understand
that
the
barriers
go
beyond
just
vaccine
specific.
You
know,
there's
a
systematic
social,
cultural,
economic
influence,
there's
an
emotional
influence,
there's
a
behavior,
cognitive
repercussion
and
then
there's
also
the
vaccine
specific
into
the
gaps.
This
really
speaks
to
what
dr
nadine
berkarez
talked
about.
F
You
know
the
institutionalized
racism,
the
social
determinant
of
how
all
these
things
are
really
influencing
how
people
are
understanding
receiving
or
even
making
decisions,
for
example,
on
the
systematic,
social,
cultural,
we're
learning
that
the
discrimination
and
equities
within
health
care
and
insurance
systems
is
is
being
magnifying,
the
not
having
health
care
or
proper
of
housing
or
access
to
food.
The
food
desert,
that's
all
magnifying
the
the
discrepancies
and
it's
influencing
these
barriers.
F
The
emotional
influence
covet
19
has
become
very
emotional
for
a
lot
of
us
for
various
reasons
and
there's
also
just
the
mechanics
of
fearing
of
the
dna
alteration.
F
F
These
are
real
gaps
that
really
are
leading
to
the
hesitancy
that
we
will
work
on
and
ensuring
that
the
education
and
information
meets
the
people's
needs
to
make
the
the
most
informed
decision
next
slide
to
continue
our
formative
research,
as
we
mentioned,
we'll
continue
to
to
monitor
the
community.
So
we
will
continue
to
have
monthly
online
boards
and
panels
that
start
next
week.
F
X
Thank
you
so
much,
and
I
want
to
thank
you
for
inviting
me
to
present
here
today.
I've
been
sitting
in
on
a
lot
of
the
sessions
and
I've
been
so
impressed
by
the
thoughtful
questions
and
conversations,
including
the
amazing
recommendations
in
the
chats.
So
I'm
going
to
present
very
briefly
work
we're
doing
around
stop.
Covid
called
stop
coven
19
ca
and
it's
share
trust
organized
partner
at
the
covet
19
california
alliance.
Next
slide.
Please.
X
So
this
was
funded
by
the
nih.
It's
a
project
that
was
funded
last
summer
to
really
focus
on
urgently
needed
community
engaged
research
and
outreach
around
coven,
19
awareness
and
education
and
it's
the
nih.
So
they
were
very
interested
in
figuring
out
ways
to
make
sure
that
there
was
a
diverse
cohort
of
patients
included
in
the
covid
trials.
X
X
Includes
11
different
academic
health
centers
and
about
70
community
partners
and
our
goals
were
multi-fold.
One
thing
we
wanted
to
do
was
really
try
to
understand
barriers
and
facilitators
to
understanding
covid19
risk
testing
and
prevention,
the
feasibility
and
acceptability
of
a
potential
of
participating
in
the
vaccine
trial
and
what
were
going
to
be
the
challenges
to
uptake
of
approved
vaccines
across
high-risk
communities
in
california.
X
X
Please
so
we
have
11
sites
across
the
state
they're
listed
here,
and
then
we
have
about
70
to
75
community
partners.
Now
next
slide.
Please.
X
The
community
partners,
you
don't
need
to
read
all
of
them,
but
I
just
wanted
to
highlight
that
they're,
a
really
diverse
group
and
they're,
often
partners
who
have
worked
with
these
institutions
for
a
very
long
time.
Next
slide.
X
So
our
project,
the
idea
behind
the
projects,
was
not
to
try
to
do
one
thing
across
the
state,
because
we
felt
that
that
would
make
no
sense,
particularly
because
many
of
these
community
partners
had
long-standing
relationships
with
the
academic
health
centers.
They
were
working
with.
So
what
we
tried
to
do
was
really
think
about
having
each
site
work
collaboratively
on
specific
projects
that
made
sense
in
their
community,
and
I
list
here
some
of
the
things
that
we've
been
working
on.
X
So
we've
talked
about,
and
many
of
these
things
are
things
that
you
as
a
group
have
discussed
and
that
the
prior
preventers
have
presenters
have
described
so
trusted
education
and
outreach
from
community
health
workers.
Community
organizations
who
are
well
known,
local
media,
their
health
fairs
that
actually
have
restarted
despite
the
pandemic
in
certain
parts
of
the
state
and
then
using
the
visual
arts
as
well.
There's
also
qualitative
research
and
I'll
describe
some
of
what
we've
found
here
and
we've
done
focus
groups
in
multi-ethnic
communities,
as
well
as
something
called
deliberative
community
engagement.
X
The
populations
we've
worked
with
are
listed
here
so
latinx,
including
monolingual
spanish
african-american,
pacific
islander,
american
indian
asian
filipino
chinese
and
south
asian,
in
particular,
essential
workers,
immigrant
populations,
including
refugee
populations,
the
lgbtq
population
and
many
low-income
groups
across
different
communities.
Next
slide.
X
Please
so
just
to
give
you
a
sense
of
some
of
the
work
that
we're
doing
statewide
we've
actually
collaborated
with
the
california
health
interview
survey
to
create
a
dashboard
of
covid
questionnaires
that
they've
developed
and
used
and
they've
also
partnered
with
others
to
deploy.
So
these
are
questions
that
they
they
use
between
march
and
september
of
2020,
and
then
we're
going
to
moving
forward
we're
going
to
be
asking
more
detailed
questions,
including
questions
about
vaccine
uptake
across
the
state.
X
As
many
of
you
know,
chiss
is
fielded
in
english,
spanish,
cantonese,
mandarin,
korean
tagalog
and
vietnamese,
and
are
we're
also
working
they're,
also
going
to
be
asking
some
questions
about
discrimination
related
to
covid.
There's
ethnic
media
outreach,
as
I
mentioned
before,
and
then
community
academic
co-development
of
training
protocols.
Next
slide.
X
So
I'm
going
to
describe
a
few
of
the
things
that
we've
worked
on.
We've
really
tried
to
take
locally
informed
approaches,
leveraging
existing
networks
and
we've
worked
with
what
people
who
have
been
considered
in
the
past
trusted
leaders.
X
So
to
date,
we've
had
about
120
coded
related
webinars
town
halls
and
community
meetings
we've
reached
about
10
000
people
on
the
first
wave.
Many
of
these
are
posted
they're
on
youtube
and
they're
accessible
going
for
future.
Viewing
in
la
in
particular,
we've
actually
worked
very
collaboratively
with
the
clinical
trials,
because
one
of
the
concerns
that
we
heard
time
and
again
is
that
people
in
the
trials
don't
look
like
us.
We've
worked
both
with
the
vaccine
trials,
but
also
the
monoclonal
antibody
trials
and
at
least
for
the
vaccine
trials.
X
We,
our
minority
participation
rate,
is
70
to
75
percent,
which
is
far
higher
than
the
national
average.
And
then
we
tried
to
disseminate
real-time
results
about
some
of
the
work
we're
doing.
Many
of
you
know
as
academics.
We
are
really
slow
and
we
tend
to
take
our
we're
very
sort
of
pokey
with
the
work
that
we
do
and
what
we've
tried
to
do
is,
as
we've
learned
things,
we've
tried
to
push
them
out
next
slide.
X
So
these
are
examples
of
some
of
the
things
that
we've
done
in
the
in
the
la
both
la
and
and
up
at
stanford.
So
we've
done
articles
for
a
local
african-american
paper,
the
sentinel
there's
a
black
health
trust
which
is
a
national
entity,
but
it's
based
in
la
and
we've
presented
on
their
national
forums
which
happen
every
week
or
every
other
week
and
then
at
stanford
they've
done
community
town
halls
where
they
do
outreach
in
english
and
spanish.
X
They
have
a
clinical
expert,
they
have
a
public
health
expert
and
they
have
a
community
expert
at
the
table
and
the
questions
are
fielded
by
provide
providers
who
type
responses
in
the
chat
in
english
and
spanish
next
slide.
Please.
X
You
know
weighing
the
risks
of
infection
versus
vaccination,
so
for
every
million
cases
of
covet
infection
there
are
about
fifteen
thousand
deaths
and
seventy
thousand
hospitalizations,
and
for
every
million
covid19
vaccinations
there
are
two
to
three
serious
reactions:
one
to
two
hospitalizations
and
one
to
two
deaths.
The
other
things
that
we've
heard
time
and
again
are.
This
is
happening
too
quickly.
So
our
team
in
san
diego
created
this
timeline
of
mrna
technology
and
talked
about
the
fact
that
this
was
developed
way
back
in
the
1990s.
X
So
it's
not
an
untested
unknown
technology
and
they
point
to
the
diverse
people.
Who've
been
involved
in
the
vaccine
development,
but
also
they
point
to
people,
local
investigators
and
local
team
members
who
have
participated
in
work
that
contributed
to
vaccine
development.
Then.
Finally,
the
the
lower
left
hand
side
shows
describes
who
was
in
the
trials
but
also
takes
a
different
spin
on
it.
It
talks
about
the
effectiveness
overall
of
the
clinical
trials,
so,
for
example,
in
moderna,
it's
94
effective
overall,
but
it
was
almost
98
percent
effective
in
people
of
color
for
pfizer.
X
It
was
95,
effective
overall,
but
100
percent
effective
in
black
black
individuals
and
94
effective
in
latinx
individuals,
so
giving
people
a
sense
that,
yes,
we
participated
in
this
and
we
benefited
from
it
just
as
much
as
those
who
weren't
those
who
traditionally
participate
in
clinical
trials
next
slide.
Please.
X
And
I'm
not
going
to
go
into
a
huge
amount
of
detail,
but
these
are
some
of
the
preliminary
themes
sort
of
were
in
these
buckets.
A
lot
of
questions
need
for
information
and
concerns,
and
many
of
the
concerns
were
pointed
to
earlier.
It
was
fetal
tissue
used
in
the
development
of
the
vaccine.
Did
the
people
who
participate
in
the
trial?
Look
like
me,
but
a
lot
of
issues
around
social
determinants
and
accessibility
and
affordability,
things
like
transportation?
X
How
am
I
going
to
get
to
the
dodger
dodger
stadium
because
it
takes
me
three
buses
to
get
there
from
south
la?
What
am
I
going
to
do
about
child
care
and
elder
care?
And
we
encountered
this
both
when
we
were
talking
to
people
about
participating
in
the
trials
and
in
in
getting
the
vaccine
and
and
we
actually
as
part
of
the
clinical
trial?
What
we
ended
up
doing
is
providing
transportation
for
people
to
get
to
on
the
clinical
trial
site.
X
X
There
were
some
population
specific
concerns,
some
concerns
about
residents,
legal
status
and
not
just
your
own
legal
status,
but
the
legal
status
of
others
in
your
family
or
others
in
the
community
and
were
you
putting
them
at
risk
by
having
people
come
to
you,
contact
tracers
come
to
the
home,
for
example,
and
I
think
there
were
also
a
lot.
There
was
also
a
lot
of
positivity
among
diffusely
among
the
different
groups.
You
know
there
was
a
ton
of
altruism.
X
The
other
thing
that
we
heard
time
and
again
is
if
someone
would
sit
down
and
talk
to
me
about
this
a
little
bit
and
answer
my
questions,
there's
a
much
higher
chance
that
I'm
going
to
participate
in
this,
and
so
I
think
we
felt
very
strongly
that
this
was
a
message
that
that
came
through
time
and
again
and
we'd
love
to
make
sure
that
people
hear
that
in
the
clinical
setting
when
I'm
seeing
patients
or
if
I'm
seeing
patients
with
the
residents,
I
always
say
make
sure
that
you
ask
people
if
they
say
I
don't
want
the
vaccine.
X
Ask
them
why
you
know
it's
not
going
to
be
an
intense
or
a
long
discussion
necessarily,
but
it
may
raise
issues
that
you
haven't
thought
about
and
and
they
may
be,
issues
that
are
potentially
addressable
and
and
if
they
don't
still
don't
want
to
do
it
that
day,
you
can
talk
to
them
about
it.
The
next
time
you
see
them
next
slide.
Please.
X
And
then,
finally,
this
is
just
we've
actually
consolidated.
Some
of
the
most
the
frequently
asked
questions
into
a
couple
of
fact
sheets.
This
is
the
english
version.
There's
a
spanish
version.
The
idea
is,
this
doesn't
necessarily
go
to
individuals
in
the
community.
X
Instead,
it
may
go
to
the
community
health
workers,
who
are
doing
the
outreach
and
we're
trying
to
do
this
electronically
so
that
as
they
they
often
say,
I
don't
have
the
answers
to
some
of
the
questions
that
are
coming
up,
but
providing
them
with
this
sheet,
giving
them
the
information
that
they
may
need.
X
And
then
I
think
the
other
thing
that
has
come
up
time
and
again
in
our
larger
working
group
is
that
there
is
a
real
need
to
make
sure
that
the
people
who
are
on
the
front
lines
providing
this
information,
get
their
questions
answered
and
their
concerns
heard
and
raised
and
addressed,
because
I
think
that
we
have
found
working
with
several
community
health
worker
groups
that
there's
reluctance
to
talk
openly
about
their
concerns
about
the
vaccine
at
times,
and
so
I
feel
sometimes
there
has
to
be
a
clearing
of
the
air,
making
sure
that
issues
around
that
distrust
of
the
medical
enterprise
and
the
research
enterprise
and
their
own
barriers
to
maybe
getting
the
vaccine
themselves
are
addressed,
open
and
explicitly.
X
So
I
think
that
is
the
last
slide.
I'm
going
to
stop
here
and
thank
you
again
for
giving
me
this
opportunity.
B
Thank
you
so
much
dr
brown,
and
at
this
point
I
want
to
recognize
that
we
are
significantly
behind
time
on
the
schedule.
I
think
we
we
wanted
to
provide
responses
to
your
many
many
questions,
but
we
might
have
overdone
it
a
little.
A
B
Our
amount
of
content
in
this
meeting
so
we'll
go
ahead
and
take
five
minutes
of
questions,
anything
that
we
can't
take
in
that
time.
Please
go
ahead
and
put
in
the
chat,
and
then
we
will
move
to
wrapping
up.
A
D
Hi
everyone
thanks
bobby
danny
chan
from
justice
and
aging.
I
feel
like
the
last
two
meetings.
I've
gone
at
the
very
end,
so
I'll
try
to
be
super
succinct.
In
my
comments.
This
is
more
of
a
comment
than
a
question
really
and
what
I'm
hoping
what
I
can
encourage
the
state
and
all
of
us
to
do
is
really
think
about
equity.
We've
talked
a
lot
about
the
different
strategies
moving
forward.
D
You
know
whether
it's
contractually
what
equity
looks
like
in
terms
of
messaging
and
I
kind
of
want
to
bring
it
back
to
1b
tier
1,
the
65
and
older
individuals
who
are
trying
to
get
the
vaccine
now,
because
it's
great
to
have
these
strategies
moving
forward
and
have
them
inform
our
strategies
moving
forward.
D
But
what
we
know
on
the
ground
we're
seeing
tons
of
disparities,
we're
seeing
you
know
in
the
news:
lots
of
disparities,
people
who
are
65
and
up
who
are
getting
the
shot
are
predominantly
white
and
that
you
know,
is
building
upon
train
tracks
that
have
long
time,
fuel
disparities
to
begin
with.
D
So
what
I
fear
that
what
we've
created
as
we're
transitioning
to
the
third
party
administrator
system
is
a
kind
of
open
system
where
you
can
go
and
get
it
if
you
can
get
it
that
really
rewards
privilege
and
access
and
capacity,
and
that
puts
people
who
are
65
and
up
and
particularly
harmed
by
covid19
older
adults
of
color
in
the
back
seat.
So
I
want.
I
know
that
we're
under
tremendous
pressure-
and
I
know
the
state's
under
tremendous
pressure
they're
doing
the
best
they
can.
D
But
I
do
want
to
lift
that
up,
because
you
know
equity
will
mean
that
older
adults
of
color
people
who
are
homebound
people
who
live
in
rural
communities.
They
need
to
have
access
just
like
everyone
else,
and
what
I
fear
that
we
aren't
spending
enough
time
on
is
drilling
down
on
strategies
to
actually
reach
these
people,
the
65
and
up
who
are
right
now
getting
vaccinated.
D
And
to
give
you
just
one
concrete
example:
if
you
don't
speak
english
or
spanish
and
you
are
living
in
the
county
of
los
angeles
and
you're,
trying
to
schedule
a
vaccination
appointment.
Good
luck,
because
the
web
page
all
it
has
other
than
ago
espanol-
is
a
globe
in
the
top
left-hand
corner
that
embeds
google
translate.
D
So
I
think
it's
great
that
we're
talking
about
equity
in
the
third
party
administrator
system,
moving
forward,
what
that
looks
like,
but
we
have
people
who
we've
already
prioritized
in
1b
tier
1,
who
need
to
get
the
vaccine
now
and
you
can
do
whatever
messaging
you
want,
but
they
need
to
actually
be
able
to
sign
up
for
a
vaccine
and
have
it
reach
them
thanks.
So
much.
I
Yeah
part
of
my
comments
really
echo
what
denny
said,
but
first
of
all
I
just
want
to
say:
oh
my
gosh,
the
incredible
work
that
the
outreach
and
engagement
team
has
done
is
just
really
amazing,
and
I
want
to
just
you
know
first
say
such
kudos,
evidence-based,
really
useful
information.
I
I
think
that
to
speak
a
little
bit
more
to
what
danny
was
saying,
I
think
a
lot
of
what
we're
talking
about
in
terms
of
outreach
is
really
about
how
to
activate
people,
but
there's
that
second
part
that
is
so
important,
which
is
the
navigation
part.
If
we
activate
people
only
to
have
barriers
like
the
website,
as
denny
mentioned,
what
what
happens
is
we
end
up
demoralizing
people
and
and
confirming
that
the
system
is
made
for
a
certain
kind
of
person?
I
And
so
that
is
my
my
big
concern
that
when
we
are
doing
all
this,
like
wonderful
outreach,
work
and
say
yes,
do
have
the
vaccine,
it's
essential
for
your
family
and
then
when
people
are
activated
they're
unable
to
make
it
and
then
they
feel
internalized
guilt,
their
family
members
feel
guilty
and
there's
a
sense
of
demoralization
again
from
the
system,
and
so
I
think
that
I
really
want
to
highlight
several
things
that
was
said
that
I
feel
are
important
solutions
to
build
upon.
One
is,
you
know,
promotores
and
other
health
navigators.
I
I
The
other
thing
I'll
say
is
that
there's
a
real
opportunity
here
using
a
place-based
approach,
because
when
we
use
a
place-based
approach,
we
have
the
opportunity
to
really
coordinate
the
activation
with
the
navigation
with
the
access
to
the
clinics
because
we're
doing
it
in
a
local
setting.
B
This
is
what
makes
this
process
better
and
we
we're
very
grateful
for
the
engagement
of
all
of
the
members
of
this
committee.
There
is,
there
is
so
much
that
was
said
in
this
meeting
and
I
typically
I
like
to
summarize
and
reflect
on
what
I've
heard,
but
I
I
recognize
that
we
are
coming
to
the
end
of
our
time,
but
I
I
want
to
highlight
that
we're
going
to
again,
you
know,
engage
in
a
process
all
of
the
questions.
B
The
questions
that
weren't
able
to
be
answered
that
were
put
in
the
chat
today
we'll
take
this
back.
Take
it
back
to
our
teams,
do
our
best
to
come
back
with
solutions
and
answers
and
responses,
and
the
the
thing
that
I
really
just
want
to
close
by
saying
is
that
your
engagement,
and
that
is
the
engagement
of
the
public
through
public
comment
and
the
engagement
of
every
single
member
of
this
committee
is
making
the
process
better
and
what
I
hope
that
you
can
see
throughout.
B
These
meetings
has
been
incredible
effort
to
incorporate
as
much
as
we
can
of
the
excellent
recommendations
and
suggestions
that
you
all
are
sharing
so
that
we
can
have
a
process
in
california,
that's
based
on
our
core
principles
of
safety,
equity
and
transparency.
So
with
that,
thank
you
so
much.
Our
next
meeting
is
september.