COMMONWEALTH OF PENNSYLVANIA HOUSE OF REPRESENTATIVES

APPROPRIATIONS COMMITTEE BUDGET HEARING

STATE CAPITOL HARRISBURG, PA

MAIN CAPITOL BUILDING HOUSE CHAMBER

THURSDAY, FEBRUARY 25, 2 021 10:12 A.M.

PRESENTATION BY THE PA DEPARTMENT OF HEALTH

BEFORE: HONORABLE STANLEY SAYLOR, MAJORITY CHAIRMAN HONORABLE ROSEMARY M. BROWN HONORABLE HONORABLE TORREN C. ECKER HONORABLE HONORABLE KEITH J. GREINER HONORABLE HONORABLE JOHNATHAN D. HERSHEY HONORABLE R. HONORABLE JOHN A. LAWRENCE HONORABLE ZACHARY MAKO HONORABLE HONORABLE TIMOTHY J. O'NEAL HONORABLE HONORABLE CHRISTOPHER B. QUINN HONORABLE HONORABLE HONORABLE JAMES B. STRUZZI II HONORABLE

Debra B. Miller dbmreporting@msn. com 2

BEFORE (continued): HONORABLE HONORABLE JEFF C. WHEELAND HONORABLE DAVID H. ZIMMERMAN HONORABLE MATTHEW D. BRADFORD, DEMOCRATIC CHAIRMAN HONORABLE HONORABLE HONORABLE HONORABLE AUSTIN A. DAVIS HONORABLE HONORABLE MARTY FLYNN HONORABLE HONORABLE HONORABLE HONORABLE HONORABLE HONORABLE BENJAMIN V. SANCHEZ HONORABLE HONORABLE JOE WEBSTER

ALSO IN ATTENDANCE: HONORABLE HONORABLE ROBERT E. MERSKI HONORABLE NAPOLEON J. NELSON HONORABLE KATHY L. RAPP HONORABLE PERRY S. WARREN

COMMITTEE STAFF PRESENT: DAVID DONLEY MAJORITY EXECUTIVE DIRECTOR RITCHIE LaFAVER MAJORITY DEPUTY EXECUTIVE DIRECTOR

ANNE BALOGA DEMOCRATIC EXECUTIVE DIRECTOR TARA TREES DEMOCRATIC CHIEF COUNSEL 3

I N D E X

TESTIFIERS

* * *

NAME PAGE

ALISON BEAM ACTING SECRETARY, PA DEPARTMENT OF HEALTH...... 4

KEARA KLINEPETER EXECUTIVE DEPUTY SECRETARY, PA DEPARTMENT OF HEALTH...... 9

LORI STUBBS FISCAL MANAGEMENT DIRECTOR, OFFICE OF THE BUDGET, SHARED SERVICES FOR HEALTH AND HUMAN SERVICES...... 13

BRIAN LENTES DIRECTOR, OFFICE OF OPERATIONAL EXCELLENCE, PA DEPARTMENT OF HEALTH...... 18

DR. WENDY BRAUND INTERIM ACTING PHYSICIAN GENERAL, PA DEPARTMENT OF HEALTH...... --

SUBMITTED WRITTEN TESTIMONY

* * *

See submitted written testimony and handouts online under "Show:" at:

https://www.legis.State.pa.us/cfdocs/Legis/TR/Public/t r finder public action.cfm?tr doc typ=T&billBody=&billTyp=& billNbr=&hearing month=&hearing day=&hearing year=&NewCommi ttee=Appropriations&subcommittee=&subj ect=&bill=&new title= &new salutation=&new first name=&new middle name=&new last name=&new suffix=&hearing loc= 4

1 P R O C E E D I N G S

2 * * *

3 MAJORITY CHAIRMAN SAYLOR: Madam Secretary, are

4 you there?

5 Madam Secretary, you may have to unmute.

6 ACTING SECRETARY BEAM: Is there any chance you

7 can hear me right now?

8 MAJORITY CHAIRMAN SAYLOR: I can hear you now.

9 ACTING SECRETARY BEAM: Wonderful. Thank you for

10 the permission to unmute.

11 MAJORITY CHAIRMAN SAYLOR: Madam Secretary, I'm

12 going to ask you to identify who you have with you today

13 and who may be testifying, and after you do that, I will

14 swear you all in and then we'll proceed to questions.

15 ACTING SECRETARY BEAM: Wonderful.

16 With me today is Executive Deputy Secretary

17 Keara Klinepeter; Acting Physician General, Dr. Wendy

18 Braund; Budget Director Lori Stubbs; and Director of

19 Operational Excellence, Brian Lentes.

20 MAJORITY CHAIRMAN SAYLOR: Very good.

21 If all of you would raise your right hand to be

22 sworn in:

23 Do you swear or affirm that the testimony you are

24 about to give is true to the best of your knowledge,

25 information, and belief? If so, say "I do." 5

1 (Testifiers responded "I do.")

2

3 MAJORITY CHAIRMAN SAYLOR: Thank you very much,

4 Madam Secretary, and to the rest of you.

5 And we will start off our questioning with

6 Representative Tim O'Neal.

7 REPRESENTATIVE O'NEAL: Thank you, Mr. Chairman.

8 And thank you for being with us, Secretary Beam.

9 Nice to see you again.

10 According to the CDC, COVID-19 vaccinations are

11 being allocated to Pennsylvania and Philadelphia, as well

12 as provided directly to select pharmacies participating in

13 the Federal Retail Pharmacy Program and the Pharmacy

14 Partnership for Long-Term Care Program.

15 What is the Department's role in each of these

16 programs, and for which program does your Department direct

17 the distribution of vaccines to providers?

18 ACTING SECRETARY BEAM: Thank you,

19 Representative, for that question. And so I will try and

20 break it down in its fundamental essence, but realizing

21 that the vaccination program is one that is evolving and as

22 is our role in each of these programs.

23 And so the State, as you correctly identified,

24 receives an allocation from Operation Warp Speed of first

25 and second doses on a weekly basis. One of the programs 6

1 that the Federal Government has established is called the

2 Federal Pharmacy Partnership Program, which is really our

3 long-term care facility mission.

4 The Federal Government chose to partner with CVS

5 and Walgreens to be able to take vaccinations into skilled

6 nursing facilities and other long-term care facilities to

7 meet the vaccination needs of both those facilities'

8 residents and staff. We, however, have to allocate the

9 vaccine to actually be able to have those clinics, those

10 vaccination clinics, conducted in the long-term care

11 facilities.

12 In the Federal Retail Partnership, the Federal

13 Government chose 19 partners to fulfill what we consider to

14 be a community mission. This is more oriented towards a

15 localized effort to have vaccines in communities.

16 Of the 19 pharmacies that it identified as

17 partners, we were able to actually use equity analysis to

18 determine our two partners of those 19 that we would

19 select. Using equity information based on our provider

20 network, we chose to partner with Rite Aid and Topco, which

21 is an umbrella corporation that has a lot of grocery stores

22 and retail drugstores throughout Pennsylvania and reach

23 some of our more difficult-to-reach communities.

24 We have also made an allocation to that program

25 on a weekly basis. About 3 weeks ago, the Federal 7

1 Government voiced its intention to actually put its own

2 allocation into that Federal Retail Pharmacy Partnership

3 Program, and realizing the extreme limitation of how many

4 doses the State has to allocate, we are now allowing the

5 Federal Government to be the entity that fulfills that

6 Federal Retail Pharmacy Partnership.

7 Two more pharmacies have recently been suggested

8 to us to operationalize. That would be CVS and Walmart.

9 We just recently allowed those partners to work with the

10 Federal Government to enhance the Federal Retail Pharmacy

11 Partnership.

12 Those are the two missions that I believe you

13 asked about.

14 REPRESENTATIVE O'NEAL: Great. Thank you.

15 Just for, I know this has been a topic of our

16 task force meetings as well. But just to clarify the

17 State's role in the Federal programs. If I heard you

18 correctly, at this point, the Federal Retail Pharmacy

19 Program is getting a direct allocation from the Federal

20 Government that is not flowing through the Department of

21 Health, but the Pharmacy Partnership for Long-Term Care is

22 actually taking a portion of the State's allocation in

23 order to run that program? Do I have that correctly?

24 ACTING SECRETARY BEAM: You do. And actually,

25 just to be able to give you the timeline, too, that is 8

1 where we were able to announce that CVS and Walgreens have

2 completed both first- and second-dose clinics in all of our

3 skilled nursing facilities, meaning that all of those staff

4 and residents have had the opportunity to actually get a

5 full vaccination if they are able to.

6 We are still working with CVS and Walgreens to

7 complete that mission, which not only entails a third

8 clinic for many of those skilled nursing facilities, but

9 also continuing the second- and third-dose clinics for our

10 personal care homes and our assisted living residences.

11 And so our allocation to that program is almost

12 complete. We almost have fulfilled what will be necessary

13 for all of those clinics to take place. But clearly, the

14 magnitude of what that was by way of undertaking has meant

15 that since we had the opportunity to, we have been putting

16 a weekly allocation to be able to have that mission

17 fulfilled throughout the past 3 months.

18 REPRESENTATIVE O'NEAL: Great. I'm getting short

19 on time here.

20 If you could, just what percentage of our

21 allocation is going to that Federal Pharmacy Program right

22 now of the total allocation. And then if you could, just

23 talk about how we are allocating the vaccines across the

24 Commonwealth outside of the Federal partnerships.

25 ACTING SECRETARY BEAM: Sure. 9

1 And so for the specific percent that is actually

2 going to the Federal Pharmacy Partnership, I might actually

3 rely on Executive Deputy Secretary Klinepeter for that.

4 But I just want to offer that I know folks have discussed

5 that they are looking at that percentage as somehow a

6 reflection of our dedication to the mission of the

7 long-term care facilities. But we have, from the onset,

8 appropriated the vaccine to that mission on a weekly basis

9 to allow it to be put into arms as quickly as possible.

10 And so it wouldn't have made sense for us to

11 front-load anymore vaccine into that program, because in

12 between the first- and second- and third-dose clinics,

13 there is a requisite 4 weeks that has to take place so that

14 the actual immunization can be in compliance with what the

15 EUA indicated. And so we have been allocating

16 proportionate to what can get delivered into arms so that

17 we don't have that inventory sitting on shelves, which you

18 know is another measurement that folks have at times taken

19 issue with us, making sure that we are absolutely

20 administering as much as has been delivered into the State.

21 Executive Deputy Secretary Klinepeter, do you

22 have the specific percentage?

23 EXECUTIVE DEPUTY SECRETARY KLINEPETER: I do not,

24 Acting Secretary Beam.

25 ACTING SECRETARY BEAM: Okay. 10

1 EXECUTIVE DEPUTY SECRETARY KLINEPETER: But I can

2 tell you that we have already set aside all of the vaccine

3 required for the skilled nursing facilities to be

4 vaccinated, and we continue to allocate every week in order

5 for the other long-term care facilities to complete their

6 missions. We're happy to follow up with you with that

7 specific number.

8 ACTING SECRETARY BEAM: And, Representative

9 O'Neal, to the remainder of your question about how the

10 rest of the vaccine allocation goes.

11 So once we get our weekly allocation, the first

12 line, the dedication to that long-term care mission is

13 first and foremost what we have allocated. Then we move to

14 making sure that we have fulfilled anything that is left in

15 the Retail Pharmacy Partnership, which as you and I

16 indicated earlier, at that point, we have really closed out

17 our dedication or allocation of vaccine to that mission.

18 And then we move to our counties and our

19 health-care partners based throughout the Commonwealth.

20 And so we use a county allocation to understand not only

21 the reflection of the population of the county, but the

22 population that is over 65 while also looking at the

23 presence of COVID, so COVID cases and COVID deaths that

24 have taken place in that county, and we come up with the

25 county allocations. 11

1 And then we do the second step of allocating to

2 our providers, which is assessing the providers that have

3 sought vaccine within a county and then allow that to be

4 the final allocation of first and second doses for that

5 week.

6 REPRESENTATIVE O'NEAL: Great. Thank you very

7 much.

8 MAJORITY CHAIRMAN SAYLOR: Next is Representative

9 Patty Kim.

10 REPRESENTATIVE KIM: Thank you, Chairman.

11 Good morning, Secretary.

12 ACTING SECRETARY BEAM: Good morning.

13 REPRESENTATIVE KIM: Secretary Beam and your

14 team, I want to first acknowledge your nonstop work and

15 efforts as we come up to the 1-year anniversary of this

16 pandemic. I know you have been conducting a 7-day

17 operation for the last 11 months.

18 Today, we will pose tough questions and demand

19 answers to the vaccine rollout and other programs in your

20 Department, as we should, and it's our job. But I felt it

21 was important to thank the individuals in your Department

22 for their work. I know everyone on your team has families

23 and the same challenges and concerns at home as the rest of

24 us, so thank you for your tireless work and serving in this

25 capacity. 12

1 My first broad question is that the Department of

2 Health received about $1.18 billion in Federal funding to

3 identify, mitigate, and vaccinate against COVID-19. And in

4 broad terms and estimated numbers, do you have a spending

5 plan to use all of it, how much have you spent down so far,

6 and do you feel that this is sufficient or will we have

7 funds left over? I know we are still in this pandemic, but

8 I just wanted to ask a broad question first.

9 ACTING SECRETARY BEAM: Thank you,

10 Representative, and I appreciate your gratitude to the

11 team. It's a humbling honor to be able to work with them

12 every day. They are tremendous.

13 With that being said, yes, we have a plan for

14 those dollars, and I'll go into the high level, but

15 Budget Director Stubbs, if you would like to go into any

16 sort of detail about what has been spent, I would

17 appreciate it.

18 So broadly speaking, there is four main areas

19 that we have been able to use the 1.18, primarily working

20 with not only our public health emergency preparedness

21 crisis money, but also hospital preparedness, our

22 epidemiology and lab capacity grants, and the immunization

23 and vaccines for children.

24 Within each of those four areas, we have had to

25 construct detailed budgets that we then send to the Federal 13

1 Government to also clarify with them our indication of

2 programmatic spend within each of those broader buckets.

3 We are also making sure that we have the right

4 staffing, that the right dedication of funds goes to our

5 county and municipal health departments. We have also

6 looked at targeted long-term testing, and many of our

7 vaccine efforts that we have spoken about with you and your

8 colleagues previously are also funded through that vaccine

9 grant.

10 With that being said, Budget Director Stubbs, do

11 you want to speak to what we have spent to date?

12 DIRECTOR STUBBS: (Audio malfunction.)

13 Okay. Can you hear me?

14 REPRESENTATIVE KIM: Yes.

15 DIRECTOR STUBBS: Okay. Sorry about that.

16 Technical issues.

17 Yes, we did have, as you have stated, we did have

18 $1.18 billion allocated to the Department. Keep in mind,

19 though, that this includes $747 million that was just

20 recently allocated through the Coronavirus Response and

21 Relief Supplemental Appropriations Act. So in the numbers

22 as I'm reporting, I am not going to include those funds

23 because although we have notice of award for those funds,

24 they have not yet been allocated. The budgets are not due

25 to the Federal grantors until March. 14

1 So of the remaining funds, which is $426 million,

2 we have committed or expended approximately 335 million, or

3 7 9 percent of the funding. And also keep in mind that of

4 that funding, the largest piece is our epidemiology and

5 laboratory capacity grant, which is still in effect for

6 another 18 months.

7 So I think we are on a great path so far as how

8 much we have spent and what our balances are to get us

9 through the next 18 months.

10 REPRESENTATIVE KIM: Great. Thank you for that.

11 You know, as we dissect the vaccine rollout plan

12 today, I want to ask another broad question, because I

13 believe we will vaccinate everyone eventually.

14 But my other concern is the impact post-pandemic.

15 To be more specific, I know that many of our households

16 during the stay-at-home orders experienced a pressure

17 cooker environment with mental health issues, physical

18 health issues, addictions, lack of financial resources,

19 domestic issues, and the like. From your vantage point,

20 Madam Secretary, what is or what will be your dashboard to

21 see trends and alarms so that we can address these issues?

22 I think the consequences will outlast the

23 pandemic years later, and that is why I was asking about

24 the broad question about our finances or the funds, if we

25 can save some for these issues that we will see when 15

1 everyone is vaccinated.

2 ACTING SECRETARY BEAM: (Audio malfunction.)

3 REPRESENTATIVE KIM: We don't hear you if you're

4 trying to speak.

5 MAJORITY CHAIRMAN SAYLOR: Madam Secretary, are

6 you there?

7 ACTING SECRETARY BEAM: Folks, can you hear me?

8 MAJORITY CHAIRMAN SAYLOR: Now we can hear you,

9 Madam Secretary.

10 Did you hear the question from Representative

11 Kim?

12 ACTING SECRETARY BEAM: I did.

13 MAJORITY CHAIRMAN SAYLOR: Okay.

14 ACTING SECRETARY BEAM: So for the IT challenges,

15 it looks like something is coming up that's saying

16 participants can't unmute themselves, and so if there's a

17 way to turn off that function. We're not able to actually

18 unmute ourselves when we go to respond to the questions.

19 And so, Representative, your question is so

20 abundantly important, and I would hope we don't derail it

21 with IT snafus.

22 A twofold answer on this one. So you have really

23 highlighted what is not only the Governor's concern but

24 also within the Department of Health the specific concern

25 with folks who really have envisioned the other side of the 16

1 vaccine being the end of the pandemic. We know that what

2 is on the other side of that pandemic, or the other side of

3 that vaccine is not going to be like what we left as far as

4 a society in 2019, and we are going to have to be able to

5 have the support systems for our society to be able to cope

6 with what will be something that is new. It will be a new

7 way of looking at our mental health systems. It will be a

8 new way of looking at our long-term care systems and making

9 sure that students that have not actually been in a

10 classroom in a year or so have the ability to transition

11 back to that classroom.

12 With that being said, narrowing in on how the

13 grant money is actually going to be spent within the

14 Department of Health's preparedness aspect of this, first

15 and foremost, we need to be prepared for the next global

16 pandemic. We know that this has been a struggle this past

17 year, because we need to make sure that we have not only

18 the data systems to support our response but that we

19 actually have the right staffing and the right resources in

20 place to be able to swiftly respond in a very strategic way

21 to whatever that next global pandemic is.

22 And so many of our resourcing decisions and the

23 like are going to really be piloted over these grant terms

24 to make sure that we understand what it will be like to

25 build for that right public health infrastructure that 17

1 needs to be there to support Pennsylvanians.

2 But then more broadly to your point about not

3 only thinking straight pandemic response but really

4 thinking about responding to what has been the trauma for

5 so many of the last year, and not just in losing our jobs

6 but even not having the normal daily routines that we were

7 used to previously. All of that has really created

8 stressors, and what we are building for is making sure that

9 our mental health system that may have already had existing

10 vulnerabilities can really handle that increased capacity

11 and our health system more broadly is going to be able to

12 handle pent-up demand for care when folks that may have

13 avoided going to the doctor just as their routine

14 appointment previously, but then also making sure that

15 we're here to really look at making sure equity is also

16 addressed. Because we know that this pandemic has not

17 played out across Pennsylvania fairly, and there are

18 populations that have had a larger impact made to them,

19 their families, and their communities, and so how do we

20 build a system that really works to address that.

21 And so I actually would like Brian Lentes to

22 chime in here on the equity aspect of it, because much of

23 the work that he is doing is not only integrating the

24 equity into our current response but also for what we are

25 building better post-pandemic. 18

1 Brian?

2 DIRECTOR LENTES: Thank you, Acting Madam

3 Secretary.

4 As Acting Secretary Beam mentioned, the

5 importance of equity across the health system and within

6 public health response is extremely important. We have

7 been able to think through this more just from a, not only

8 from a COVID-19 response but also thinking through where we

9 go next steps and beyond.

10 One of our most important large partnerships is

11 the Health Equity Response Team, which has been extremely

12 important to the COVID response, but this team is also

13 focused on directing social determinants of health and then

14 how those social determinants impact the public and also

15 the health outcome.

16 We began to really look at different agencies'

17 activities, organizations who will partner with us and be

18 able to bring up issues that their constituents and also

19 population, vulnerable populations have been experiencing

20 across the Commonwealth. These types of social activities

21 regarding anything from incarceration to activities in

22 mental health, all of those activities are things that we

23 will be able to review within program levels and also

24 activities outside.

25 REPRESENTATIVE KIM: All right. Thank you so 19

1 much, Mr. Chairman. Thank you for the time.

2 MAJORITY CHAIRMAN SAYLOR: Madam Secretary, we

3 have allowed you to mute or unmute yourselves---

4 ACTING SECRETARY BEAM: Thank you.

5 MAJORITY CHAIRMAN SAYLOR: ---but the feedback is

6 coming from you when multiple people have their microphones

7 unmuted there. So if people would keep their microphones

8 muted until they are called upon, it will help us keep from

9 the feedback.

10 Also, Madam Secretary, I have allowed for both

11 sides to have long answers here, but we really need to

12 speed this up. We need shorter answers to these questions

13 so that Members are able to ask multiple questions if they

14 need to. So I'm just reminding you to please keep your

15 answers as short as possible.

16 With that, we will move to Representative

17 Rosemary Brown.

18 REPRESENTATIVE R. BROWN: Thank you,

19 Mr. Chairman.

20 Good morning, Madam Secretary.

21 ACTING SECRETARY BEAM: Good morning.

22 REPRESENTATIVE R. BROWN: I want to discuss the

23 actions of the Department of Health specifically on the

24 vaccination distribution plan during the most critical time

25 for public health in the last 100 years, for Pennsylvania 20

1 especially.

2 "Chaotic," "disorganized," "inefficient," are

3 very light terms to describe the Department of Health's

4 distribution plan. With months to plan for this,

5 Pennsylvanians have not been protected to the level that

6 they deserve.

7 As you know, a poor distribution plan equals poor

8 vaccination administration. I know you mentioned that in

9 the first question. PA currently is listed as 38 out of 50

10 of the number of people vaccinated. Let's not forget what

11 we're talking about. We're not just talking about numbers,

12 we're talking about lives. We're talking about preventing

13 illness and preventing deaths. This is an extremely

14 serious subject. They deserve serious answers,

15 Pennsylvanians, in regards to this plan, and no matter what

16 the supply is, efficiency, organization, and communication

17 are essential.

18 Each State had the sole authority to develop this

19 distribution plan and vaccination plan, and it's not a

20 Federal decision. On February 12th, the Department of

21 Health announced that future distributions of first doses

22 to providers would be based on a provider's achievement of

23 certain metrics, including administering at least

24 80 percent of first doses within 1 week of delivery. It

25 also said that performance would drive first doses, 21

1 high-performing providers.

2 I would like to know exactly, based for your

3 responsibility, the pool of vaccine doses that the

4 Department of Health is responsible for, what those metrics

5 are and how these allocation decisions are being made.

6 ACTING SECRETARY BEAM: Thank you,

7 Representative.

8 Specific to the allocation question. So first,

9 let's talk about the provider network. We have, luckily we

10 have over 1800 providers in Pennsylvania that want to be

11 our partners in being vaccinators. That is fantastic.

12 However, having all 1800 providers receive vaccine when we

13 as a State are still receiving such a limited amount of a

14 weekly allocation really had created a network that was

15 larger than really warranted at this moment in the vaccine

16 rollout. And so we knew that we needed to take what was

17 our small vaccine allocation and concentrate it in

18 providers that could really handle the demands of our

19 current rollout.

20 I know there is a significant urgency that

21 everyone is feeling, you from your constituents and us from

22 a tremendous amount of stakeholders about the need to get

23 vaccinated right now. And so by us concentrating the

24 vaccine at the providers that could actually handle that

25 demand, we were going to be able to capitalize on what is 22

1 right now circumstance.

2 I say that cognizant that we are going to be at a

3 point in weeks and months when hopefully the supply far,

4 far, far exceeds what we're currently getting, but our

5 problem will be demand, and we're going to have to--

6 MAJORITY CHAIRMAN SAYLOR: Madam Secretary, I

7 don't think you are answering the question that the lady

8 asked, and that's what I'm saying here. We need the short

9 answers. Answer the questions that both sides of the aisle

10 ask you directly. Don't go into other metrics or other

11 areas. We need answers. There's a lot of people here

12 today who have questions from their constituents and

13 concerns. Please answer the questions that the Members ask

14 you.

15 Thank you.

16 ACTING SECRETARY BEAM: Sure.

17 So for the allocation strategy, it's two parts.

18 First and foremost, after we have done the long-term care

19 facility dedication and any of the Retail Pharmacy

20 Partnership obligation that is left, we look at what is

21 left to spread to the health-care providers within the

22 66 counties that we are responsible for. Philadelphia

23 still receives its own allocation.

24 For that county breakdown, there is a calculation

25 that is based on not only the population of the county but 23

1 the population that is over 65, the presence of COVID cases

2 currently in the county, and the deaths that have been

3 experienced by that county because of COVID.

4 Once we have the county breakdown, we look at the

5 provider enrollment, and the provider enrollment is

6 cognizant of that order that was issued 2 weeks ago to be

7 able to actually have providers that can move those first

8 doses within a week of receipt, be able to receive volumes

9 of first doses, because again, we know that folks are eager

10 to get that first dose. From there, we are able to have

11 any other additional doses also allocated. And remember,

12 this is just first doses.

13 For second doses, we have stayed true to the

14 principle that the second dose follows the first dose.

15 When we actually have to allocate those second doses, we

16 make sure that they follow the first dose. Where that

17 first dose was administered, there should be a second dose.

18 And so we have been able to stay I think on that

19 schedule by way of having our allocation of first doses

20 really have volume and urgency, and our second doses follow

21 the first dose.

22 REPRESENTATIVE R. BROWN: Thank you,

23 Madam Secretary.

24 And are the providers being notified in an

25 appropriate timeframe over the last several months? The 24

1 providers were getting a pending notice on their computer

2 the day before an allocation would arrive. I don't know

3 how anyone is supposed to be able to plan for clinics or

4 administration effectively and schedule with that type of

5 communication.

6 ACTING SECRETARY BEAM: So we receive

7 notification from the Federal Government of our weekly

8 allocation, and we immediately work on what our allocation

9 of first and second doses will be for that week following.

10 And so the clear provider communication comes in

11 a letter that states not only the first doses that they

12 will receive and should administer within that requisite

13 7 days, but then also the second doses that they should

14 receive, that they should have already anticipated and

15 scheduled for.

16 To your point about having to schedule on such

17 short notice, one of the things that we have been able to

18 actually hear from the provider community directly is just

19 that. They have the ability to quite quickly schedule at

20 this point in time because of already having realized

21 dedicated staff resources that could be cross utilized, but

22 really because they know that their communities are eager

23 to get vaccinated. And so we have had indications that

24 folks have been able to have a 1200-person clinic actually

25 get signed up very, very quickly, within a day's notice, 25

1 because of the urgency of right now.

2 REPRESENTATIVE R. BROWN: Thank you,

3 Madam Secretary. The communication must build.

4 Thank you very much.

5 MAJORITY CHAIRMAN SAYLOR: The next questioner is

6 Representative Bullock.

7 REPRESENTATIVE BULLOCK: Thank you, Mr. Chairman.

8 Good morning, Madam Secretary.

9 ACTING SECRETARY BEAM: Good morning.

10 REPRESENTATIVE BULLOCK: So there has been a lot

11 of talk in recent months, and at this point a year, in

12 regards to structural racism in our health-care system,

13 particularly as it relates to racial disparities that have

14 been exacerbated by this pandemic.

15 I have been working with your office to codify

16 the Office of Health Equity, and I'm also working on

17 separate legislation that would establish a joint

18 legislative committee on equity and allow for equity impact

19 statements on legislation. These efforts can help make our

20 health system more anti-racist and more equitable.

21 However, simply calling for racial equity offices and

22 impact statements is nothing without resources.

23 Can you share with me what specific investments

24 your Department has made in communities of color in regards

25 to vaccines, testing, and outreach during the pandemic? 26

1 And what general investments do you believe you need are

2 necessary to have a more equitable and anti-racist

3 health-care system in the Commonwealth?

4 ACTING SECRETARY BEAM: Thank you,

5 Representative. I'll start, but then Director Lentes, I'll

6 turn it over to you.

7 So just to hit on two discrete examples that are

8 really responsive to your question.

9 So remember, one of our most tremendous resources

10 throughout this pandemic response has been not only tests

11 but also vaccine, right? Those are the commodities that we

12 have really utilized as one of our most significant

13 investments. And so in testing, one of the examples that

14 we always really like to lift up is our successful

15 partnership with the Latino Connection.

16 The Latino Connection was able to go into

17 communities that we know were not necessarily eager to have

18 COVID-19 testing, and they surely didn't have it as easily

19 accessible to them as other communities. And it was able

20 to be a bridge into the communities so that the testing

21 facility in its mobility, which was fantastic, but it

22 wasn't met as a foreign effort and it was really helpful in

23 getting inroads in certain populations that hadn't

24 naturally been having that COVID testing to understand the

25 presence of the virus. 27

1 Separate and apart from that is our vaccine

2 allocation, and we had mentioned this as a brief overview,

3 but I do want to take time to explain that in that retail

4 partnership decision, we relied on equity data to truly

5 understand how we were going to reach communities that were

6 not necessarily those that were traditionally served by

7 large hospitals and large systems. We wanted to make sure

8 that we were getting to the pockets, getting to minority

9 communities, and allowing that to drive who we partnered

10 with, which is where we started with Rite Aid and Topco,

11 because of not only their presence in Pennsylvania but also

12 the communities that they reach specifically, and now we're

13 building out with CVS and Walmart.

14 Brian, I'm going to go on mute, if you don't mind

15 picking up or continuing.

16 DIRECTOR LENTES: Thank you, Acting Secretary

17 Beam.

18 Just going off of her last description of the

19 pharmacy practices, we are looking at our Retail Pharmacy

20 Program. It's very important to note, and going to your

21 point, Representative, that the Health Equity Response Team

22 played a major role in this. We have also looked at the

23 allocation process based on assessment for our most

24 vulnerable population. It's important to note that we have

25 taken time to look at census data, population social risk 28

1 factors, population health statuses, and also make sure

2 that we have been able to target campaigns within those

3 areas.

4 By working with our partners, who have been the

5 pharmacies in that program, they have been able to provide

6 us ideas or a list of pharmacy locations. We have been

7 able then to identify geographically where the most

8 vulnerable areas are and where are the most areas of need,

9 specifically vulnerable populations of residents.

10 In addition to that, we have been able to

11 identify where those rural areas are to meet their vaccine

12 or pharmacy deserts. So I think on that point, it has been

13 very helpful with the actual distribution.

14 Going to testing, Acting Secretary Beam mentioned

15 about the Latino Connection. We have also been able to

16 focus our AMI contracting, which is focused on reaching the

17 different counties for testing opportunities. We have been

18 able to take our vulnerability index and look at where the

19 needs are most and greatest. I think that has been very

20 important for racial minority application and also our

21 vulnerable populations.

22 REPRESENTATIVE BULLOCK: Thank you.

23 Can you also share with me any work you are doing

24 and investments you are making to address hepatitis in the

25 Commonwealth and testing and treatment? 29

1 ACTING SECRETARY BEAM: Yes, Representative. We

2 are glad to.

3 And we have actually made inroads both on

4 hepatitis A and hepatitis C. I know that in addition to

5 some of the detail that Executive Deputy Klinepeter will

6 outline by way of our hepatitis investments, I do just want

7 to take this as an opportunity to also speak to the

8 opportunity for partnership on syringe services and making

9 sure that as we know that hepatitis C has a linkage to

10 those that have had drug use in the community, we want to

11 make sure that to the extent that we can truly work

12 together on that legislation, we would be very open to

13 those conversations.

14 Executive Deputy Klinepeter?

15 EXECUTIVE DEPUTY SECRETARY KLINEPETER: Thank you

16 very much, Acting Secretary Beam.

17 So with regards to our work in hepatitis A, we

18 had spent a significant amount of money looking at how to

19 identify high-risk groups, particularly at the height of

20 the epidemic where individuals were also experiencing

21 homelessness and incarceration. Perhaps Deputy Director

22 Stubbs could speak to that exact figure.

23 As well with hepatitis C, we have sent a

24 significant amount of investment looking at how to work

25 with stakeholders and developed and received a grant in 30

1 order to work on this public health program.

2 Director Stubbs, do you have those figures

3 available?

4 DIRECTOR STUBBS: Yes.

5 As far as the hepatitis C grant, I believe we get

6 approximately $400,000 a year. That's a Federal grant. As

7 far as any State funds that we are using related to

8 hepatitis, I'm afraid I don't have that in front of me, but

9 I'll be happy to follow up with a response.

10 REPRESENTATIVE BULLOCK: Thank you. I appreciate

11 your answers.

12 Thank you, Mr. Chairman.

13 MAJORITY CHAIRMAN SAYLOR: Our next questioner is

14 Representative Natalie Mihalek.

15 REPRESENTATIVE MIHALEK: Thank you, Mr. Chairman.

16 Good morning.

17 On March 18, 2020, the Pennsylvania Department of

18 Health issued its first guidance to nursing homes regarding

19 COVID-19. I specifically want to draw your attention to

20 the "admissions" language in the order that states,

21 "Nursing care facilities must continue to accept new

22 admissions and receive readmissions for...residents who

23 have been discharged from the hospital..." for COVID-19,

24 and this was made immediately applicable to all nursing

25 facilities in Pennsylvania, even though at that time, none 31

1 of them had a dedicated COVID unit.

2 Just 2 days ago at a press conference,

3 Governor Wolf, in response to a question from the Altoona

4 Mirror specifically on the March 18th order, said that this

5 is not something the Commonwealth in any capacity said that

6 we should do.

7 We also know that, from testimony from Secretary

8 Torres, that the Department of Aging was not consulted

9 prior to the issuance of this order. So who was behind

10 this decision to issue the order to have nursing homes

11 accept COVID-positive patients?

12 ACTING SECRETARY BEAM: Thank you,

13 Representative. I appreciate that.

14 So the Department was following the guidance of

15 the Centers for Medicare and Medicaid Services, CMS, our

16 Federal regulator and the Federal regulator truly of

17 nursing homes as well. We have been working with them

18 throughout the pandemic response, and at that point, CMS

19 had really put forth guidance really reflective of the fact

20 that folks were very worried about our hospitals being able

21 to actually withstand what was the oncoming surge of

22 COVID-19.

23 And so---

24 REPRESENTATIVE MIHALEK: So, ma'am, who was

25 behind the decision to issue the order? 32

1 ACTING SECRETARY BEAM: The order is a Secretary

2 of Health order. It is guidance issued by the Department,

3 and so the Secretary of Health, but also in consultation

4 with all of the deep bench of scientists that we have here

5 at the Department. We are the ones who issued the guidance

6 in following the CMS guidance at the Federal level.

7 REPRESENTATIVE MIHALEK: Well, no, because the

8 Federal guidance, if you are following Federal guidance,

9 then no separate order is needed. You would just simply

10 say to the nursing homes, we're following Federal guidance

11 on this one. It would be less confusing for everybody than

12 to issue a new order. But that's not what the Department

13 of Health did. They issued an order on March 18th that

14 differed from Federal guidance, that was more strict, that

15 demanded that COVID-positive patients be put back into the

16 nursing homes, among the most vulnerable to the population.

17 We knew from those early cases, before we had any

18 cases here in the United States, we were following in

19 Europe what was going on, and the people who were dying,

20 the most vulnerable to the virus, were the people that are

21 in our nursing homes. They are our seniors, the most

22 vulnerable, and what did we do? We issued an order on

23 March 18th directing that vulnerable population to accept

24 COVID-positive patients. So I'm trying to get to the

25 bottom of who was behind that decision and why. 33

1 ACTING SECRETARY BEAM: Sure.

2 So I'll start by saying that our guidance, while

3 it may have been clearer, was not different from the

4 Federal guidance. But Executive Deputy Secretary

5 Klinepeter, do you want to speak to the detail on that?

6 REPRESENTATIVE MIHALEK: Well, it was different

7 from the Federal guidance, and I'm going to pull it up.

8 The Federal guidance that was in place at that time would

9 have come from CMS on March 13th, and it states, and just so

10 we're on the same page here, I'll just go ahead and read

11 it:

12 "When should a nursing home accept a resident who

13 was diagnosed with COVID-19 from a hospital?

14 "A nursing home can accept a resident diagnosed

15 with COVID-19...," and it goes on to say that as long as

16 the facility can follow CDC guidance for transmission.

17 That is very different from the Department of

18 Health order just issued 5 days later with regard to the

19 admissions and discharges, as I have already said.

20 "Nursing care facilities" -- this is from the Pennsylvania

21 Department of Health -- "must continue to accept new

22 admissions and receive readmissions...who have been

23 discharged from the hospital... This may include stable

24 patients who have had the COVID-19 virus." That's

25 different. Those are two different things. 34

1 EXECUTIVE DEPUTY SECRETARY KLINEPETER: Thank

2 you, ma'am. This is Executive Deputy Secretary

3 Keara Klinepeter.

4 So specific to why those are different, in your

5 words, as Acting Secretary Beam said, our guidance was more

6 clear for facilities, but it was not different. In fact,

7 at that time, CMS encouraged States to make guidance that

8 was appropriate for their community.

9 As you recall, in the spring, there were States

10 that were untouched by COVID, unlike Pennsylvania who was

11 significantly impacted by COVID. And so at the time, CMS

12 encouraged States to issue clarifying guidance, which we

13 did.

14 REPRESENTATIVE MIHALEK: And it was very clear

15 that our nursing homes were to accept COVID-positive

16 patients, and other States did not have a similar order.

17 We are number three. Usually when you're talking about

18 Pennsylvania, we're at the bottom of the list for

19 everything, but we're right up at the top now,

20 12,338 nursing home deaths, and this order contributed to

21 that. That's more than half of the deaths in this State.

22 We're in front of Texas, and we're in front of California.

23 If you're looking at total population,

24 Pennsylvania has 12.8 million residents -- 12.8 million.

25 We're in front of Texas, who has 29 million residents. 35

1 We're in front of Florida, who has 21 million residents.

2 We have 12, yet our nursing home deaths surpass, and this

3 order contributed to it.

4 Madam Secretary, with everything that is in front

5 of you today, everything that we have heard over the months

6 about these deaths in our nursing homes, could you just say

7 to us today that that March 18th order was a mistake?

8 ACTING SECRETARY BEAM: I' ll offer first that we

9 wanted to make sure that our hospitals were not overrun.

10 We knew at that time that other countries were experiencing

11 hospitals that were overrun, and we wanted to make sure

12 that to the extent it could be done safely, individuals

13 were back in their homes recovering from COVID-19, and

14 their homes, in many instances, are the facilities that we

15 are speaking about today.

16 REPRESENTATIVE MIHALEK: So was that order then a

17 mistake?

18 ACTING SECRETARY BEAM: We worked with the

19 Federal Government to make sure that the guidance that was

20 issued was then clarified at Pennsylvania levels. So for

21 our Pennsylvania facilities that were likewise trying to

22 find a path forward at a time that was very confusing---

23 REPRESENTATIVE MIHALEK: Thank you, ma'am. I

24 appreciate your loyalty to the order. I would not want to

25 be the one to look in the eyes of those loved ones of those 36

1 12,338 people and stand by this order. That's all.

2 Thank you, Mr. Chairman.

3 MAJORITY CHAIRMAN SAYLOR: Madam Secretary, the

4 fact that you were avoiding the answer clearly makes it

5 clear that it was a mistake. I don't know why when you

6 make mistakes you can't agree that a mistake was made.

7 So with that, we'll move on to Representative

8 Austin Davis.

9 REPRESENTATIVE DAVIS: Thank you, Mr. Chairman.

10 Madam Secretary, thank you for joining us today.

11 I, along with a number of my colleagues, our

12 phone lines are crushed by constituents who are struggling

13 to locate where to get a vaccine. I joined a number of

14 my colleagues here a few weeks ago to introduce the COVID

15 Vaccine Registry Act, and I believe I brought that up

16 directly with you on calls, as well as a number of my

17 colleagues.

18 What is your position on a COVID vaccine

19 registry?

20 ACTING SECRETARY BEAM: Thank you so much,

21 Representative.

22 So this has been an issue, like you said, we have

23 engaged on this multiple times. I think it's helpful if

24 you would allow me just to quickly go through the roles

25 that different actors are playing to explain why a 37

1 centralized registry right now may not be something that

2 the State should be setting up.

3 REPRESENTATIVE DAVIS: So I'll ask you to do it

4 very concisely.

5 ACTING SECRETARY BEAM: Extremely concisely.

6 The Federal Government buys, manufactures, and

7 ships all vaccine. They are in charge of all of that. The

8 providers are the ones who are actually administering the

9 shots. They are putting the shots into those arms. They

10 are scheduling the appointments to get their patients those

11 shots.

12 The State is in charge of those phases, letting

13 people know when they can go get vaccinated. The where, we

14 do the allocation and we get the data back to make sure

15 that we have an understanding of who got vaccinated where.

16 Right now, as far as a centralized registry goes,

17 we have the Federal system that has the Vaccine Finder that

18 has their up-to-date information on where a vaccine has

19 been shipped. We likewise have providers using their

20 scheduling systems.

21 The State has used the Your Turn tool to allow

22 folks to know whether or not they are in their phase and

23 can go get vaccinated or alert them when the Commonwealth

24 progresses to their phase.

25 If we are in the phase and they are in the phase 38

1 that the Commonwealth is currently in, they can then use

2 the map to actually identify the provider and go get the

3 appointment with the provider scheduling system that the

4 provider community has absolutely invested in.

5 REPRESENTATIVE DAVIS: So--

6 ACTING SECRETARY BEAM: With that said -- I'm

7 sorry. Go ahead, Representative.

8 REPRESENTATIVE DAVIS: No; go ahead.

9 ACTING SECRETARY BEAM: I was just going to offer

10 that the Department stands at the ready to have technology.

11 If there is a success demonstrated by a technology that

12 could be stood up to embody what so many folks have

13 contemplated as a centralized registry, which I also think

14 we should try and get on the same page with because folks

15 have different visions of what that registry really means

16 and entails, we're open to those conversations.

17 We have not seen a demonstrated technology yet

18 that would be able to turn around as quickly as this

19 vaccine rollout requires of us and meet the needs of what

20 folks are trying to really contemplate as an overarching

21 umbrella over that Federal system, the State system, and

22 the provider systems and the interoperability that that

23 would require. But we are not closing the door on it, and

24 I want to be sure to be clear on that.

25 REPRESENTATIVE DAVIS: All right. Thank you. 39

1 So I'm certainly willing to work with you on

2 that. I think we have seen it work in other States. We

3 need a more streamlined process, quite frankly. This is

4 just creating chaos. We have people who are spending hours

5 waiting on different lines just to try to schedule an

6 appointment, only to be told that there are no appointments

7 available. It's contributing to a lack of equity in the

8 way the vaccine is being distributed. So I would hope that

9 you would be willing to work towards that goal.

10 Secondly, I want to bring up an issue. You know,

11 I represent the McKeesport Area School District. They have

12 done a phenomenal job of offering a hybrid learning, both

13 in-person instruction as well as virtual, throughout this

14 pandemic. Since September 1st, they have had kids in the

15 classroom.

16 What is your position on the prioritization of

17 teachers, of teachers in the vaccine process, to get as

18 many kids back into school as possible?

19 ACTING SECRETARY BEAM: So we know that right

20 now, phase 1A is large, and it exceeds anything near what

21 we are actually receiving by way of vaccine allocation. We

22 know that if we transition into phase 1B with the teachers

23 and the critical first responders that we know are in that

24 category, along with our grocery store workers and

25 manufacturers, that allowing them permission to get the 40

1 vaccine is not consistent with actually getting vaccinated.

2 And what we want to make sure is that when we transition

3 in, that we can actually secure a vaccination for those

4 teachers so that they can get back into the classroom

5 safely, because it's not just the permission to go get a

6 vaccine, it's, we want to get them vaccinated.

7 And so to the extent that there are forthcoming

8 investments from the Federal Government, meaning more

9 supply, there is actually more manufacturing of vaccine or

10 new vaccines, which are very close in the queue right now,

11 we can have those discussions. But we want to make sure

12 that we don't set up a false premise whereby we have

13 ourselves progressing to a phase but the actual vaccines

14 aren't there to secure the vaccination for folks.

15 REPRESENTATIVE DAVIS: Thank you.

16 When do you envision, based on the new Johnson &

17 Johnson vaccine, when do you envision we will move, or your

18 projections, move into the 1B phase?

19 ACTING SECRETARY BEAM: So this is a real-time

20 discussion. We are learning real time what is happening

21 with Johnson & Johnson, meaning that the Federal Government

22 has not fully approved it yet. Right now and into

23 tomorrow, they will be working on that.

24 But I want to really curtail expectations here,

25 because the Federal Government has even caveated that the 41

1 actual supply of the Johnson & Johnson vaccine is less than

2 what we had anticipated as far as the Pfizer and Moderna.

3 It's just the size of the investments and the manufacturing

4 to date.

5 And so while I am hopeful that the Johnson &

6 Johnson vaccine would provide us a path to progressing

7 through those phases more frequently, we also want to be

8 careful to temper expectations, because from what we're

9 learning of the Federal Government, it' s a smaller amount

10 of vaccine that's actually coming whenever Johnson &

11 Johnson gets approved, if it does.

12 REPRESENTATIVE DAVIS: Thank you. And it seems

13 my time has concluded.

14 I just would like to close with a comment that I

15 know you guys have put out guidance to reprioritize larger

16 pharmacies who can distribute larger amounts of vaccine to

17 folks. I certainly understand your reasoning for doing

18 that.

19 I would just suggest that there are a number of

20 small communities like that I represent and many folks

21 represent where transportation access is a barrier, and

22 access to those larger distributors is a barrier. So I

23 hope that your Department will keep an eye towards equity

24 as it relates to that, because we are dealing with a number

25 of structural impediments. 42

1 And with that, thank you, Mr. Chairman. I

2 conclude my questions.

3 MAJORITY CHAIRMAN SAYLOR: Our next questioner is

4 Representative Meghan Schroeder.

5 REPRESENTATIVE SCHROEDER: Thank you, Chairman.

6 Secretary Beam, thank you for being here.

7 ACTING SECRETARY BEAM: Thank you. It's our

8 pleasure.

9 REPRESENTATIVE SCHROEDER: Can you share with us

10 the dates each version of the vaccine plans were released

11 to the public, because I was trying to find them on the DOH

12 website and I cannot see them.

13 ACTING SECRETARY BEAM: Yeah. That will be one

14 that our team will actually get back to you. We have

15 version 5 out right now, which means that there are five

16 dates that you would be seeking. And so our team can work

17 on getting that to you.

18 REPRESENTATIVE SCHROEDER: Okay. So we are on

19 version 5. All right.

20 So on January 19, 2020, the Department of Health

21 expanded phase 1A eligibility to include phase 1B and 1C,

22 expanding the eligible population to nearly 4 million

23 people. What was the estimated number of individuals in

24 the original phase 1A, and what percent of these people

25 have been vaccinated as of the date of January 19th? 43

1 ACTING SECRETARY BEAM: So remembering that the

2 original phase 1A was that long-term care facility mission

3 that we had spoken about previously and our health-care

4 personnel, I don't want to speak out of turn. I will get

5 back to you with exactly what we had used as an estimate of

6 what the initial phase 1A population was.

7 And then you are correct that with the addition

8 of those over 65 and the 64 and under with underlying

9 comorbidities, it grew to roughly 3.5 to 4 million.

10 REPRESENTATIVE SCHROEDER: Well, I think it's

11 really important to know that number, because we just added

12 a bunch more people into one phase without, it sounds like,

13 planning for that. So can you explain your rationale for

14 the January 19th eligibility expansion to nearly one-third

15 of the State when individuals who live in congregate care

16 settings, where more than half of Pennsylvania's

17 COVID-related deaths have occurred, were not vaccinated and

18 there was and continues to be a supply chain issue and a

19 supply shortage?

20 ACTING SECRETARY BEAM: Thank you for

21 highlighting the supply shortage as well. I feel like we

22 have been saying it a lot, but this is obviously one of the

23 main concerns right now, is whatever we can do to have the

24 Federal Government---

25 REPRESENTATIVE SCHROEDER: But you're the one 44

1 saying that we have a limited supply, but then you put a

2 bunch of individuals into one phase where we don't have

3 enough to vaccinate those people. So you set this

4 expectation that has failed the people of Pennsylvania.

5 They believe that they are now going to get a vaccine

6 quicker because we added them to this phase, and

7 unfortunately my office and many Members here that we have

8 open offices dealing with constituents are telling them,

9 I'm sorry, I can't get ahold of the DOH live or the

10 Governor's Office live. I can't explain why we would do

11 that. It sounds like a logistical nightmare. But what do

12 you suggest is the rationale for that, though?

13 ACTING SECRETARY BEAM: So as laid out in those

14 plans, we followed the Federal guidance very, very closely

15 in making sure that phase 1A had the long-term care

16 facilities and the health-care personnel. When Federal

17 guidance came out that advised that those over 65 and those

18 64 and under with specific comorbidities that the CDC had

19 then issued guidance on should be added to phase 1A, we

20 adopted that guidance into our guidance as well.

21 And so simply as we had done previously with

22 conforming to the Federal guidance for our phases, we then

23 allowed the Federal Government's guidance to enhance---

24 REPRESENTATIVE SCHROEDER: Well, it's the Federal

25 Government's guidance, but as a Department of Health, don't 45

1 you make those decisions? Like, we keep hearing it's the

2 Federal Government, the CDC. Those are guidelines. You

3 make the ultimate decisions. So somebody in your

4 Department made that decision without thinking ahead.

5 But here's also to touch on that. While

6 researching, going through my emails, I found out that two

7 press releases came out from your office on January 19th

8 within 6 minutes of each other, one stating the major

9 changes to the phase plan for vaccine eligibility and one

10 announcing Dr. Levine's departure. It seems like a lot was

11 going on in your office on that day. Did this create a

12 communication problem with getting the word out for the

13 phase 1 expansion?

14 ACTING SECRETARY BEAM: So the phase 1 expansion

15 was alluded to by the Federal Government days prior, and so

16 we had also indicated that we were conforming to the

17 Federal guidance, just as we had done previously. There

18 was the formal announcement and the adjustment to our plan

19 that would also have to take place. That was announced on

20 the date that the press release was issued.

21 We also want to make sure that the rationale

22 behind the Federal Government's explanation is here, too.

23 Our seniors, as we have talked about throughout this

24 hearing, were a population that really were at risk

25 throughout our COVID-19 response. 46

1 REPRESENTATIVE SCHROEDER: We know that, so then

2 why did we -- you know, from the beginning, the supply

3 chain we have known is a problem, and then you're adding

4 all those people when you're trying to take care of that

5 vulnerable population and adding more people in it. Just

6 realistically, I think that's common sense that does not

7 make sense.

8 But I want to also ask, how much advance notice

9 did the Department give vaccine providers to prepare for

10 the expansion of phase 1A? Because I feel like that's a

11 really important question.

12 ACTING SECRETARY BEAM: So we typically have a

13 rollout that includes a preview of any sort of changes

14 within the day prior to the announcement. I can check with

15 our team to see exactly when the providers were notified,

16 but that would be the typical routine that the provider

17 community is made aware of changes such as that.

18 REPRESENTATIVE SCHROEDER: Okay. I would

19 appreciate that. And I just think while we go forward here

20 setting expectations, they have to be realistic, and when

21 we tell people they're going to get a vaccine quicker

22 because they're in a new phase now, and that's really not

23 logistically possible, I would like the honesty there.

24 But thank you for being here today, and thank

25 you, Chairman. That concludes my questions. 47

1 MAJORITY CHAIRMAN SAYLOR: Madam Secretary, I

2 must say I am a little shocked as Chairman of the

3 Appropriations Committee that you don't have numbers. You

4 had to know that somebody was going to ask you the question

5 about nursing homes and how many people had been vaccinated

6 in those, and I'm very disappointed that those numbers are

7 not available today.

8 You had to have been briefed or should have been

9 briefed in those kinds of numbers to come here before the

10 Democratic and Republican Appropriations Committee and not

11 be able to give Members of both sides of the aisle a clear

12 understanding of how many people have been vaccinated in

13 those areas. These are Members who represent 12.8 million

14 people in Republican and Democratic districts who have to

15 go back home and ask the senior citizens and loved ones who

16 have people in the nursing home what's going on. Those are

17 numbers that should be readily available to you as the

18 Secretary of Health and should be communicated to every

19 Member of the General Assembly, but most importantly, right

20 here to the Appropriations Committee, Madam Secretary.

21 And with that, I'm going to move on to

22 Representative Peter Schweyer.

23 REPRESENTATIVE SCHWEYER: Well, thank you for

24 that, Mr. Chairman.

25 Madam Secretary, thank you for being here today. 48

1 Listen, tempers are running high; we all know

2 that, but we also all know we're all in this together -­

3 Democrats, Republicans, the Administration, the

4 Legislature. We know that the private sector and public

5 sector are all working together to try to get as many

6 vaccines in the arms of Pennsylvanians as we possibly can.

7 But the one thing that I really, really want to continue

8 hammering home on is the question of equity.

9 Representative Davis beforehand was talking about

10 getting educators vaccinated and moving them up on the

11 list, and yes, we all understand that there is a supply

12 problem. However, not every school district is equal. Not

13 every school district is exactly the same.

14 I represent the city of Allentown, only the city

15 of Allentown, only the Allentown School District. I have a

16 school district of 17,000 kids with buildings that were

17 built as early as 1871. We have classes with 35, 42 kids

18 in them, and I have had Legislators, colleagues of mine,

19 very well intentionally say to me, well, why don't you just

20 put Plexiglas all over the desks to be able to return your

21 students to class? We don't have desks in every one of our

22 classrooms. We have a lot of tables where social

23 distancing is darn near impossible.

24 Our kids in the Allentown School District have

25 been 100 percent virtual, including my two daughters who 49

1 are students in this district, since last year. We have no

2 real ability to get back in the classroom unless our

3 teachers are getting access and getting vaccinated. This

4 isn't a pitch for our schoolteachers to be bumped up over

5 somebody else; this is a pitch for equity in one of the

6 poorest communities in the Commonwealth of Pennsylvania.

7 Further exacerbating the problem, Madam

8 Secretary, is, on the Your Turn website, it still doesn't

9 have translation services. I have kids that speak

10 30 different languages from over 50 different nations of

11 origin in the Allentown School District, and the basic tool

12 that they have to be able to give themselves the

13 opportunity to get vaccinated is not even provided in a

14 language that they can use.

15 So as we're talking about equity, please

16 understand that not every community is the same. We have

17 excellent health-care networks in Allentown and the

18 Lehigh Valley. We have a tremendous health bureau that is

19 trying their very best. But equity means a lot of

20 different things, and I'm really going to ask you for more

21 flexibility, understanding that there are different parts

22 of the Commonwealth that have very different issues.

23 Madam Secretary, I'll stop pontificating, and now

24 I'm going to ask you for your plans moving forward.

25 ACTING SECRETARY BEAM: Absolutely. 50

1 So first, let's hit on the equity and the

2 language. Just on the Your Turn tool specifically, just to

3 let you know, by next week, we'll have three more

4 languages. I believe it's German, Mandarin, and Spanish

5 that will be coming out next week.

6 But to the point that many of our vaccine

7 materials -- and actually, our COVID response materials are

8 being translated in over a hundred languages currently. We

9 hope to be able to expand that Your Turn tool technology to

10 also be reflective of the broad swath of languages that we

11 are currently deploying on our COVID response across the

12 board.

13 I think equity in our school districts is

14 particularly important, and understanding and appreciating

15 the circumstance that your students and your children are

16 in right now is exactly why we are trying to think through

17 creative ways to be able to get students back into school,

18 but doing it safely. That is the most important part of

19 all of this. And so as the CDC has continued to issue

20 updated school guidance and as we have learned about any

21 sort of potential for further vaccine ability, this

22 Governor prioritizes education, as do we as a Department of

23 Health, and we know what it means by way of equity.

24 With that being said, Brian, I feel as if I want

25 to give you an opportunity just to speak, because this is 51

1 such an area of passion for you.

2 DIRECTOR LENTES: Sure. And thank you,

3 Mr. Representative, for the question.

4 Across the Commonwealth, all the areas are

5 different. Some key things that we have done that we feel

6 very strongly with our reactions to our COVID-19 response

7 is, while we think about activities within the different

8 regions, we developed limited English proficiency handouts

9 for all the testing sites and also our community and local

10 health departments that assist with marketing and also test

11 and service advancement.

12 Two different things that are continuing to move

13 forward are town hall developments where we will be in

14 communities to talk in person, and as the Secretary

15 mentioned, the Your Turn application is being translated.

16 In addition to that, we have over 109 different translated

17 services on the Department of Health's website, and we

18 continue to work through video clips and also partnership

19 to encourage trusted messenger services in the different

20 communities, and that will be with partnership joint

21 efforts.

22 So we are starting to see that moving forward, so

23 I believe there is a lot of activity happening.

24 REPRESENTATIVE SCHWEYER: There are two parts —

25 if I can interrupt. There are two parts to this point. 52

1 Number one, when we're talking about education

2 equity, there is a massive health component to it. And

3 again, all of the suburban districts around the Allentown

4 School District are able to be in their schools safely. It

5 is not the Department of Health's fault that we have aging

6 buildings. It is not the Department of Health's fault that

7 we have overcrowding in our urban classrooms. It is,

8 however, the Department of Health's opportunity to be able

9 to reduce the inequities between our school districts that

10 have versus the school districts that are have-nots by

11 helping those kids get back into the classroom quicker,

12 knowing that they have unique needs.

13 The second question is, the Your Turn website was

14 introduced weeks ago -- weeks ago. I sat on our caucus

15 call when you were unveiling these things. Like, why was

16 this not part of it from day one? I just fundamentally

17 don't understand how we could just simply ignore hundreds

18 of thousands of Pennsylvanians who don't have English as

19 their primary language. You said you're doing it in

20 German? Nobody speaks German in Allentown. We have a

21 whole lot of Arabic speakers in Allentown.

22 So as you continue to move forward, please engage

23 your partners in the Legislature. I'm not trying to be

24 adversarial. I am not trying to be an impediment. I am

25 offering my help to the best of my ability to say that we 53

1 collectively as a Commonwealth are missing huge parts of

2 our Commonwealth, number one. And number two, we need to

3 understand that not every community is the same and we need

4 to address their needs differently.

5 I see my time has run out. I may have further

6 questions later. But I do appreciate you all very much.

7 Thank you, Mr. Chairman.

8 MAJORITY CHAIRMAN SAYLOR: Next is Representative

9 Jesse Topper.

10 MAJORITY VICE CHAIR TOPPER: Thank you,

11 Mr. Chairman.

12 Madam Secretary, good morning.

13 ACTING SECRETARY BEAM: Good morning.

14 MAJORITY VICE CHAIR TOPPER: On February 17th,

15 it was kind of a rough day for Pennsylvania as we learned

16 that as many as 60,000 second doses were, and I read this

17 several ways in different articles. Some said

18 "incorrectly." Some said "by mistake." Some said

19 "accidentally." But at the end of the day, we had about

20 60,000 second doses that were administered instead as first

21 doses.

22 Can you explain to this Committee and to our

23 constituents maybe a better understanding of how the

24 Department tracks the allocation and the administration of

25 COVID-19 vaccines? 54

1 ACTING SECRETARY BEAM: Sure. I can go through

2 the tracking, but I do want to say that that was, as you

3 said, it was a tough day, but we did this I think with

4 communication being first and foremost of how to fix it,

5 and I don't want to lose that point today either.

6 So for our allocation strategy by way of tracking

7 it, we not only have our allocation science, which has the

8 county breakdown that I have already spoken about, and then

9 the provider breakdown tracked, but we also have reporting

10 systems whereby the providers then report back in to us

11 once that shot that got delivered to them as a facility is

12 actually administered into an arm.

13 And so that's our ability to understand how

14 quickly the providers are using it, making sure that

15 they're actually doing it with urgency, and especially with

16 the demands at the moment that we currently have in front

17 of us, that that reporting was then doubled down on. And

18 that 80-percent order that we talked about previously, they

19 have to get us that information within 24 hours, and it has

20 to be complete. They have to--

21 MAJORITY VICE CHAIR TOPPER: Okay.

22 ACTING SECRETARY BEAM: ---not only have the

23 gender but the race and the ethnicity for that to be our

24 data to then drive further decisionmaking.

25 MAJORITY VICE CHAIR TOPPER: So within 24 hours. 55

1 So at this point -- let's take it from right now.

2 Are you getting, when a provider administers the first

3 dose, within 24 hours, are you getting that information?

4 Do you have to go get that information? Are providers

5 getting it to you on time? In other words, do you know

6 right now how many first doses are being administered on a

7 daily basis?

8 ACTING SECRETARY BEAM: We do. We have the

9 information from providers of what is being administered on

10 a daily basis. I'm happy to run through it, too, if that

11 would be helpful.

12 MAJORITY VICE CHAIR TOPPER: Well, I was going to

13 say, is that how this mistake came to light? Because it

14 was about 4 weeks, I think, in between. What was the, if

15 it's supposed to be 24 hours, I guess I'm wondering what

16 the lag time was between when these doses were administered

17 and when we found out they were administered, or is that a

18 new procedure that has gone on since?

19 ACTING SECRETARY BEAM: So, our highlighting it

20 in the order was to make sure that everyone is complying

21 with it. We knew that there was at least data lag that we

22 needed to be able to address to allow it to be something

23 that could build upon the accountability, which was really

24 the overarching theme of that order, was making sure that

25 providers were held accountable to it. 56

1 At this stage, we have a very high level of

2 compliance with the 24 hours. I actually don't quite know

3 if there are any providers that aren't doing that, but

4 that's what our team is actively engaging with those

5 providers. And again, as we take our provider network and

6 we focus it from 1800-plus and really work on honing in on

7 that ability to have 200 to 300 providers that are doing

8 this quickly and equitably and reporting accurately, we're

9 going to be able to have a more informed strategy moving

10 forward.

11 MAJORITY VICE CHAIR TOPPER: If the Department -­

12 I guess we need assurances that the Department is

13 monitoring this correctly, because there was a lot, there

14 was immediately a lot of confusion and concern in our

15 districts about now the efficacy of those second doses that

16 were used as first doses. Have we fixed that problem for

17 that segment of people?

18 ACTING SECRETARY BEAM: Yes. So where there was

19 any sort of delay in that second dose getting into an arm,

20 at max, it was at 42 days, which means it moved back a week

21 or, at max, 2 weeks, and then---

22 MAJORITY VICE CHAIR TOPPER: Well, wait a minute.

23 Help me understand, because I can just sometimes be a dumb

24 country boy here.

25 The second dose, they are going to be applied, 57

1 but does that mean that the dose they got first actually

2 worked, even though it was supposed to be the second dose?

3 ACTING SECRETARY BEAM: I understand what you're

4 asking now. Yes, they are the same medicine. So the first

5 dose is the exact same medicine as in the second dose. And

6 so yes, their first dose worked as a first dose and the

7 second dose came through as a second dose.

8 MAJORITY VICE CHAIR TOPPER: So the same

9 medicine, we're just giving them at two different times,

10 and those 60,000 residents of Pennsylvania are now back on

11 schedule?

12 ACTING SECRETARY BEAM: Yes. We are in the fix

13 right now. We are working through making sure that by -­

14 there's 2 to 3 weeks to smooth out. As I said, they have

15 to kick it to 5 weeks or 6 weeks, but then we will be in

16 the clear and they will have their second doses completed.

17 MAJORITY VICE CHAIR TOPPER: In your testimony

18 you had said that you executed a plan when you took on this

19 role, which is a very, you know, very large role, for more

20 frequent and clear communication across the organization.

21 There has been a concern that throughout the

22 Department of Health, there has been a lack of

23 communication, not just amongst the other Departments but

24 even within the Department itself and certainly within

25 legislative offices around the Commonwealth, and I hope 58

1 that with you being in this position, we can see an

2 improvement in that communication.

3 Thank you, Mr. Chairman.

4 MAJORITY CHAIRMAN SAYLOR: Our next questioner is

5 Representative Fiedler.

6 REPRESENTATIVE FIEDLER: Thank you, Mr. Chairman.

7 Thank you, Acting Secretary, for being with us.

8 I represent South Philadelphia, and our city's

9 vaccination program is in many ways very different and

10 separate from the rest of the States. In Philly, I have

11 some serious concerns, honestly, about how we're locating

12 vaccination clinics and making difficult decisions about

13 how to divvy up our limited doses of the vaccine. The

14 result, as we've all heard, whether in Philly or across the

15 State, is that senior citizens and people with serious

16 health conditions are left to travel a great distance to

17 get the vaccination that they qualify for and that could

18 save their life.

19 In Philadelphia, I am told that decisions about

20 where to site vaccination sites and where to focus it are

21 being made based on areas hit hardest by COVID, those with

22 the lowest vaccination rates, and with other factors

23 considered such as equity. Could you talk about how the

24 State determines geographically where to focus vaccinations

25 across the State and whether you reevaluate that process in 59

1 any sort of ongoing way?

2 ACTING SECRETARY BEAM: Yes. I'm happy to speak

3 to that.

4 So first, culture of continuous improvement here.

5 We are reevaluating our strategy, making sure that we are

6 allowing ourselves the ability to get better every single

7 day.

8 With that being said, to the question about how

9 equity plays into our actual allocation strategy, what we

10 have been working with is not only the counties, and as we

11 have discussed, there is the county allocation to make sure

12 that we get the geographical spread of the 66 counties

13 we're responsible for. But when you look at the providers

14 within each of the counties that can actually avail

15 themselves of being a provider of vaccine, we are also

16 looking at what they are conducting by way of anything

17 oriented towards really being an opportunity for the

18 community to come in, meaning they have to be open to

19 having folks, not just something that they have set up by

20 way of who they want to have be in 1A and that they can

21 actually come and get a shot rather than having it be open

22 to the general public, which was incredibly important.

23 The one thing I would offer is that our equity

24 analysis has especially come in when we have talked about

25 our community vaccination clinics and our mass vaccination 60

1 clinics. This is in close conjunction with Director

2 Padfield from the Pennsylvania Emergency Management Agency,

3 and he's actually best suited to speak to it.

4 But Brian, I know you have actually been helping

5 him with equity information to inform where we would set up

6 those community vaccination clinics and mass vaccination

7 clinics, if you wouldn't mind speaking to that.

8 DIRECTOR LENTES: First off--

9 REPRESENTATIVE FIEDLER: And I'm sorry to jump

10 in. Just for one second, because I know my time is limited

11 and I would like to hear your thoughts as well. But if I

12 could also just ask what level of communication you have

13 right now with the Philadelphia Health Department and with

14 city officials about your vaccine rollout, their vaccine

15 rollout, and what level of coordination or sharing of best

16 or worst practices is going on between the city and the

17 State, please.

18 ACTING SECRETARY BEAM: Sure. I'll speak to

19 that, and then, Brian, if you want to speak.

20 So first we should set up that Dr. Farley, the

21 Director of the Philadelphia Department of Health, and

22 Allegheny County and the State meet every other day to make

23 sure that we are trying to stay as closely coordinated as

24 we can with two large metropolitan areas, one receiving its

25 own supply of vaccine, as you know well, from the Federal 61

1 Government, the other really working with us through that

2 vaccine allocation strategy. And so we keep in close

3 contact with obviously those that are in charge of running

4 the health departments in those local jurisdictions, and

5 obviously our front office and our Governor's Office stays

6 and keeps in close contact with the leadership of both of

7 those cities.

8 Go ahead, Brian.

9 DIRECTOR LENTES: Sure.

10 Director Padfield of the Emergency Management

11 Agency has been a supreme partner in rolling out this

12 strategy. We have taken the time and careful

13 considerations for our vaccine distribution based on

14 vulnerable populations and looking at really census data

15 and population and social risk factors in identifying where

16 are those areas in need, so those being where there are no

17 pharmacy or providers located; also, the populations who

18 are maybe more susceptible to COVID-19 and more severe

19 outcomes from contracting COVID-19.

20 PEMA then works with us carefully to identify

21 which partners, being the counties. The local municipal

22 authorities are able to assist with holding up a vaccine

23 site for the community. This continues to roll out, and

24 probably most recently we have seen there have been several

25 conducted in a few different counties. 62

1 And this assessment continues to evolve, to your

2 point of the evolution on this, and we look at the

3 continued identifications through the CDC on underlying

4 health conditions and then identifying social risk factors

5 that relate to those as well.

6 REPRESENTATIVE FIEDLER: Thank you very much.

7 Thank you both for responding.

8 I wanted to ask you finally how you would rate

9 Pennsylvania's vaccination program compared to other

10 States .

11 And if I can just real quick before I ask you to

12 answer that, a recent article by Jenice Armstrong in the

13 Philadelphia Inquirer, who lives across the bridge in

14 New Jersey, it really struck me, and she said that compared

15 to Philadelphia's situation and situations in many other

16 places, her experience in New Jersey was totally different.

17 And I'll just say very quickly, she said, "On the day of my

18 appointment, several weeks later, my husband dropped me off

19 at the former Lord & Taylor store turned vaccine mega

20 site." She was given hand sanitizer. Her temperature was

21 checked. "It didn't take long before I was sitting down,

22 injected, and then directed to the observation area, where

23 personnel check for allergic reactions. Back in the car, I

24 glanced at my cellphone. The entire process took barely

25 3 0 minutes." 63

1 So I'll ask you just in final, compared to other

2 States, including our neighbors, how do you believe

3 Pennsylvania's vaccination program ranks?

4 ACTING SECRETARY BEAM: So I just want to offer

5 that if you look at how many vaccines that we have been

6 allocated as a State versus how many we have administered,

7 we're always fifth or sixth, right? This Governor has been

8 very clear that just doing what is expected of you is not

9 going to cut it, and he wants us to be better than where we

10 are right now.

11 And so by being fifth or sixth and having the

12 fifth or sixth allocation I think is doing average and we

13 have the opportunity to improve, and that is why we have

14 dedicated ourselves to increasing not only the

15 communication but the transparency and the strategy behind

16 having a Pennsylvania solution that actually affords each

17 Pennsylvanian the experience that that individual wrote

18 about.

19 REPRESENTATIVE FIEDLER: Thank you for that.

20 So would you say that you feel like we are doing

21 better than other States or falling behind? If you could

22 just answer the original question, please.

23 ACTING SECRETARY BEAM: So I think we are doing

24 exactly proportional to what we have been allocated. We

25 are, again, administering fifth or sixth in the nation, and 64

1 we have been allocated fifth or sixth in the nation. But I

2 think we can do better by way of administration and allow

3 there to be better urgency behind getting those shots into

4 arms.

5 REPRESENTATIVE FIEDLER: Thank you, and thank you

6 to all the workers who are trying so hard to save lives. I

7 appreciate it.

8 MAJORITY CHAIRMAN SAYLOR: Representative

9 John Lawrence.

10 REPRESENTATIVE LAWRENCE: Madam Secretary, before

11 I ask my question, I just have to follow up on my

12 colleague's question from Philadelphia.

13 The CDC website, I checked last night,

14 Pennsylvania has received 3.5 million vaccines and we have

15 administered 2.5 million vaccines. That's a million shots

16 that are on the shelf, and you're trying to tell this

17 Committee here today that we're fifth or sixth in the

18 nation? That's ridiculous. Could you please clarify that

19 statement?

20 ACTING SECRETARY BEAM: Absolutely.

21 So by way of shots actually delivered, which is

22 what the CDC uses as their terminology, we are typically

23 between fifth and sixth. This is in between us and

24 Illinois, and by "administered," we're between fifth or

25 sixth. 65

1 The CDC used to use a delivered versus

2 administered metric, which they recently changed this week,

3 because they realized that that was actually rushing out

4 second shots.

5 REPRESENTATIVE LAWRENCE: But, Madam Secretary,

6 that's because we're a larger State. If you look at the

7 percentage basis, which is what matters, not how many

8 people we have in the State. If you're trying to say how

9 many shots have been administered versus how many people

10 are in the State, I mean, come on.

11 If you look at other States and compare it to the

12 percentages that the other States have administered versus

13 what we have administered, as I said, no other -- I mean,

14 I checked the website last night. They have delivered

15 3 ^ million shots and we have administered 2 ^ million

16 shots. That means a million shots are on the shelf.

17 That's not a lack-of-vaccine problem. That's not a

18 shortage problem. We want more vaccines. There certainly

19 is a shortage. I'm not trying to say there isn't. But

20 when I see 3 ^ million have been delivered and 2 ^ million

21 have been administered, that's not a shortage problem,

22 that's a logistics problem, and you're in charge of

23 logistics for vaccines in Pennsylvania.

24 ACTING SECRETARY BEAM: So those are making sure

25 that those second doses, too, that we had talked about last 66

1 week, are actually going to get into arms within that

2 proper timing. We do not want folks to rush second doses

3 to have some sort of higher metric by what was actually

4 administered into arms. We want to make sure that it's

5 done on the proper calendar.

6 And we know that States have been able to

7 actually achieve a higher ratio of delivered to

8 administered by having those second shots rushed out. But

9 second-dose security is incredibly important to us, and the

10 reason that it's important is that just getting a first

11 dose and then having to scramble for the second dose is

12 something that really puts Pennsylvanians at risk, because

13 we want to make sure--

14 REPRESENTATIVE LAWRENCE: But, Madam Secretary,

15 with all due respect, the 2 ^ million, the Feds have said

16 they have delivered 3 ^ million and 2 ^ million have been

17 administered. Many in the 2 ^ million bucket include the

18 second shots that have been administered to people.

19 I do want to move on to the actual question I

20 wanted to ask because my time is limited. Let me ask you

21 this, Madam Secretary:

22 At a recent press conference, Governor Wolf

23 stated, and this is a direct quote, "Nursing homes,

24 100 percent of staff and patients who wanted the COVID

25 vaccine have gotten it." Is that true? 67

1 ACTING SECRETARY BEAM: So we have been able,

2 through that Federal Pharmacy Partnership, which is what

3 that actual press conference was about, the Federal

4 Pharmacy Partnership through CVS has delivered 283,566

5 total doses. That is indicative of first- and second-dose

6 clinics being completed at the skilled nursing facilities

7 that CVS oversees. And for Walgreens, it is 46,187 total

8 doses administered. So--

9 REPRESENTATIVE LAWRENCE: So, Madam Secretary,

10 that sounds like a couple hundred thousand. There are

11 millions of seniors in Pennsylvania. I want to know, was

12 the Governor correct? He stated point-blank at a recent

13 press conference, "Nursing homes, 100 percent of staff and

14 patients who wanted the COVID vaccine have gotten it." Is

15 that true?

16 ACTING SECRETARY BEAM: The first- and

17 second-dose clinics at all of our skilled nursing

18 facilities are complete.

19 REPRESENTATIVE LAWRENCE: Yes or no, is that

20 true? Was the Governor telling the truth---

21 ACTING SECRETARY BEAM: Yes.

22 REPRESENTATIVE LAWRENCE: ---to the people of

23 Pennsylvania on this issue of vaccines? Was the Governor

24 telling the truth? "Nursing homes, 100 percent of staff

25 and patients who wanted the COVID vaccine have gotten it." 68

1 Is that the truth?

2 ACTING SECRETARY BEAM: Yes. Through the Federal

3 Pharmacy Partnership, we have been able to actually have

4 100 percent of the staff and residents who want the vaccine

5 to get it. We brought it to them. Yes, the Governor is

6 stating a true statement.

7 REPRESENTATIVE LAWRENCE: But, Madam Secretary,

8 first of all, you're talking about, I believe, this Federal

9 Partnership Program. There are 700 facilities that

10 qualify; 600 of them signed up. One in seven didn't sign

11 up. So we know one in seven don't fall into this number of

12 where the Governor is saying, "Nursing homes...." He

13 didn't say "participating." He didn't say -- in fact, I

14 would really question it. He wasn't -- I don't think he

15 was referring to folks living in assisted living. I don't

16 think he was referring to folks in independent living.

17 Look, we're getting calls at my district office

18 every day from people who live in nursing homes, who are

19 desperate to get the shot and can't even figure out how to

20 sign up for one, but the Governor is running around at a

21 press conference saying, nursing homes, 100 percent of the

22 people who wanted one, they got it.

23 ACTING SECRETARY BEAM: That's the skilled

24 nursing facilities. You are right, the personal care homes

25 and the assisted living residences are still in progress. 69

1 We're working on our first- and second-dose clinics.

2 First-dose clinics have been completed there, but

3 they still need the second dose, and so that's why the

4 Governor differentiated and had the skilled nursing

5 facilities set out. But we have completed a hundred

6 percent of the first- and second-dose clinics for those

7 skilled nursing facilities.

8 REPRESENTATIVE LAWRENCE: Madam Secretary, my

9 time has expired and I don't want to go over, but I will

10 say that is doublespeak like I rarely have seen in front of

11 this Chamber.

12 Thank you, Mr. Chairman.

13 MAJORITY CHAIRMAN SAYLOR: Next is Representative

14 Kinkead.

15 REPRESENTATIVE KINKEAD: Thank you, Mr. Chairman.

16 Thank you, Madam Secretary.

17 I would like to discuss the vaccination of

18 persons with disabilities. It is well known that the

19 disability population is at higher risk for death or

20 serious symptoms if they contract COVID. The majority of

21 these folks are in group 1A and eligible to receive

22 vaccines if they can access them. However, currently, the

23 blind and visually impaired cannot access the map with an

24 e-reader, and additionally, individuals with mobility

25 issues who rely on technology, such as those with cerebral 70

1 palsy, cannot navigate the map with their devices. How is

2 the Department going to address this, what is the timeline

3 for addressing it, and why was disability access not

4 prioritized in the rollout of this feature given the

5 obvious need to get individuals with disabilities the

6 vaccine because of their inclusion in the 1A category?

7 ACTING SECRETARY BEAM: Thank you.

8 So that is why we rely on our 1-877 line. So

9 just by way of staffing up our 1-877 line, a year ago we

10 had three individuals staffing that line, now we have over

11 320 individuals staffing that line, with a recent

12 investment of folks to be able to handle exactly this,

13 which is the vaccine inquiries.

14 And what we want to have on that line are folks

15 that are first able to translate. As we have already

16 highlighted, they have multiple translators that are

17 actually able to be on that line. But also have service

18 quickly delivered to those folks, and right now, the

19 average wait time is around 3 minutes on that 877 line.

20 While we want to get better, and we're not saying that

21 3 minutes is acceptable, we also know that that line can

22 serve to meet the needs of a lot of the constituencies that

23 you are discussing right now, such as the disabled

24 population or anyone that has difficulty with our Your Turn

25 tool or our map. 71

1 REPRESENTATIVE KINKEAD: I appreciate that, but I

2 do believe that access to this map is also a critical

3 feature, and I'm wondering how you are going to increase

4 accessibility to that.

5 ACTING SECRETARY BEAM: So the map really is the

6 location of providers that can then have that appointment

7 scheduled for them.

8 When somebody calls the 877 line, they are

9 stepped through exactly that: the information that is

10 conveyed on the map, the providers, and then the actual

11 ability to get the appointment scheduled. And so the

12 facilitation of the appointment scheduling is really what

13 the map is there for, and that's what the 877 line serves,

14 as really the safeguard to allow there to be other channels

15 to have the same utility.

16 REPRESENTATIVE KINKEAD: Okay. Thank you.

17 ACTING SECRETARY BEAM: Mm-hmm.

18 MAJORITY CHAIRMAN SAYLOR: Next is Representative

19 Clint Owlett.

20 REPRESENTATIVE OWLETT: Thank you, Mr. Chairman,

21 and thank you, Secretary, for being here.

22 I'm going to follow up on my colleague's

23 questioning about this misleading statement at very best

24 from the Governor that Representative Lawrence was talking

25 about. 72

1 Currently, I mean, we have about 700 skilled

2 nursing homes, and about 600 of them, he talked about one

3 in seven, they are not part of this Federal program. Would

4 you agree with those numbers? Is that, according to your

5 data, is that accurate?

6 ACTING SECRETARY BEAM: It's actually inaccurate.

7 Six hundred and fifty of our skilled nursing facilities are

8 participating in the Federal Pharmacy Partnership.

9 REPRESENTATIVE OWLETT: Okay. So what about the

10 50 that are remaining? Where are we at with them? I mean,

11 obviously the Governor wasn't talking about them. Or those

12 50, they would have contracted or worked with the

13 Department of Health, correct?

14 ACTING SECRETARY BEAM: So not necessarily with

15 the Department of Health. To be clear, those individuals

16 who opted out generally were individuals that already had

17 an established relationship with a community pharmacy,

18 because we actually followed up to say exactly that: Why

19 did you opt out of this program? Do you have another

20 channel for getting vaccinated? And they had a preferred

21 partner that they wanted to use alternative to the Federal

22 Pharmacy Partnership, which we were not going to stand in

23 the way of.

24 REPRESENTATIVE OWLETT: So how specifically did

25 you reach out to them? 73

1 ACTING SECRETARY BEAM: Our team was reaching

2 out, but Executive Deputy Klinepeter, if you want to speak

3 to it.

4 EXECUTIVE DEPUTY SECRETARY KLINEPETER: Sure.

5 We actually called them. We did a crosswalk

6 between who enrolled in the Federal Pharmacy Partnership

7 and all licensed skilled nursing facilities, and then we

8 called the facilities to understand the specifics that they

9 were dealing with and to ensure that they were taken care

10 of.

11 REPRESENTATIVE OWLETT: So are you directing

12 vaccine to these partners that are working with these

13 50 nursing homes?

14 ACTING SECRETARY BEAM: So those were primarily

15 the pharmacies, and the pharmacies are absolutely still

16 part of our provider network. That is what we have talked

17 about when even narrowing our provider network either

18 through the Retail Pharmacy Partnership, or frankly, a lot

19 of our independent pharmacists as well are all those that

20 are getting it from the---

21 REPRESENTATIVE OWLETT: Yeah. But are you

22 prioritizing them? I mean, we're talking about our nursing

23 homes, and the press conference said the nursing homes were

24 done. Are we prioritizing vaccines to these remaining

25 50 nursing homes--- 74

1 ACTING SECRETARY BEAM: Yes.

2 REPRESENTATIVE OWLETT: -- and are they complete?

3 Are they complete?

4 ACTING SECRETARY BEAM: I will have to check to

5 make sure that I don't speak about their clinic completion

6 yet, but we are prioritizing vaccine to those pharmacies

7 where they partnered with the nursing homes outside of the

8 Federal Pharmacy Partnership.

9 REPRESENTATIVE OWLETT: Can you see how this

10 would be, in our communities, misleading at best? I mean,

11 you don't even know. I mean, you came before this

12 Committee not knowing if all of these nursing homes have

13 had their vaccines.

14 ACTING SECRETARY BEAM: So all of the nursing

15 homes, the 650 of the 700 that participate in the Federal

16 Pharmacy Program---

17 REPRESENTATIVE OWLETT: Yeah. I'm talking about

18 the 50 that didn't. That's what I'm here to talk about. I

19 get the Federal Partnership. I got that. I'm talking

20 about the 50.

21 ACTING SECRETARY BEAM: So the 50 we have worked

22 very closely with. As Executive Deputy Klinepeter stated,

23 we called. We wanted to make sure, again, we didn't want

24 them missing an opportunity to participate in a program

25 that would get their residents and their staff actually 75

1 vaccinated as quickly as possible.

2 And so we followed up intentionally, doing the

3 outreach to these facilities to say, one, why did you opt

4 out; and two, how are you facilitating it otherwise? That

5 allows us to actually have the allocation to the pharmacies

6 that they are partnering with and so that they are moving

7 on a timeline hopefully that is similar to what CVS and

8 Walgreens have been able to deliver. But we also want to

9 make sure that they are getting the vaccine from the State,

10 first and foremost.

11 REPRESENTATIVE OWLETT: I get that, but whose

12 idea was it to go out and say that all of the nursing homes

13 have been covered, and we even here today, you are not

14 prepared to tell us where we're at with those 50. Can you

15 understand the frustration that we are hearing about, and

16 can you recognize that and say that it was probably not the

17 best idea to go out there and say that all nursing homes

18 have got their vaccine?

19 ACTING SECRETARY BEAM: So I'll acknowledge the

20 frustration broadly. We know, and it has already been

21 acknowledged in this hearing today, everyone's emotions are

22 running high. We are trying abundantly to communicate

23 clearly. And in speaking about the skilled nursing

24 facilities in a press conference with CVS about the Federal

25 Pharmacy Partnership, especially lifting up their 76

1 successes, we wanted to make sure folks knew our dedication

2 to those skilled nursing facilities.

3 REPRESENTATIVE OWLETT: And I would recommend

4 that maybe in the future, whoever writes those quotes and

5 press conference releases to say, well, we're not finished

6 yet, and we still have 50 that we're working with and we're

7 trying to get to them.

8 I'm almost out of time, but you mentioned that

9 the emotions are running high, and they are, and I think

10 the reason that they are running high is that we had time

11 to prepare for this. You know, emotions were running high

12 with testing, and I get it. That was early on. You know,

13 I understand. But we had time to prepare for this, and

14 that's why everybody is frustrated and that's why emotions

15 are high.

16 It didn't have to be this chaotic, and it didn't

17 have to be this unorganized. Communication does not have

18 to be a problem, logistics do not have to be a problem, but

19 they are, and that's why people are frustrated. That's why

20 the folks at the Commonwealth are frustrated.

21 And I appreciate the task force that the Governor

22 has started. That should have been, you know, from day

23 one. But I understand that there's an opportunity now to

24 engage with the Legislature and engage with us, and that's

25 important, and I do appreciate that. But we have to do 77

1 better and we have to do better for the constituents of the

2 Commonwealth here, and we can and we must.

3 So thank you for being here, and thank you,

4 Mr. Chairman.

5 MAJORITY CHAIRMAN SAYLOR: Next is Representative

6 Webster.

7 REPRESENTATIVE WEBSTER: Thank you, Mr. Chairman.

8 And Secretary, thanks for joining us this

9 morning. I think it's still morning, and I appreciate you

10 have been on the hot seat here answering the hard questions

11 and dealing with the whole legacy of a pandemic and both a

12 Federal and State complex situation.

13 I would like to spend a few minutes sort of

14 pulling back to the day-to-day responsibilities of public

15 health and this budget in front of us, and I will preface

16 that by saying, as an adult, I have spent most of my adult

17 years not in Pennsylvania, so I have been a little bit

18 stunned, is probably the right word, to return, and I'm

19 going to talk about lead in our water and testing of, you

20 know, lead poisoning in our children. I have been stunned

21 to find out that Pennsylvania has such a large issue over

22 water quality.

23 So if you would, my understanding is, maybe

24 20 percent of our children get a blood test for lead

25 poisoning. Those that are involved in Medicare or CHIP are 78

1 supposed to get tested twice, and we might do that half the

2 time. Can you talk to us, please, about, you know, the

3 program for testing, what's in the budget, what are the

4 barriers for getting this right, and talk a little bit

5 about what we need to do to take care of the health of our

6 children a little bit more?

7 Thank you.

8 ACTING SECRETARY BEAM: Thank you,

9 Representative.

10 So I'll highlight three of our primary lead

11 programs right now, and then, Director Stubbs, if you

12 wouldn't mind speaking to the dollars behind these

13 programs. If there's any detail on them, I would

14 appreciate it.

15 So first is our Lead Hazard Control Program.

16 This is where we are actually using the United States

17 Department of Housing and Urban Development as our partner

18 in making sure that we have the ability to have lead-based

19 paint inspections of houses and also have hazard control

20 put in place where we can put remediation efforts into the

21 homes where we know lead is present.

22 We also have our Childhood Lead Surveillance,

23 which also brings up your point about making sure that we

24 are focusing in on really preventing that lead exposure to

25 our children. This actually has childhood lead data tests 79

1 completed and compiled in a way that allows us to identify

2 the potential high-risk areas, and then we can actually do

3 community needs assessments based on our surveillance

4 through this program.

5 This is where we have also invested in hiring the

6 epidemiology team to support this effort, because again,

7 even though that we have an epidemiology team that

8 obviously has been very overworked this last year through

9 COVID-19, we cannot forget that our epidemiology team does

10 still have a responsibility for the environmental programs,

11 and we're making sure that we are investing in that team

12 and building it out appropriately.

13 The third is outreach and education, and we have

14 actually been able to have our community health nurses

15 continue their work on the lead remediation, and

16 particularly the childhood exposure to lead, throughout

17 this pandemic, which is incredibly important for us to,

18 again, not lose the progress that we had made in so many

19 areas just because of the pandemic requiring us to make

20 resources cross-utilized or the like.

21 And those would be the three programs. Director

22 Stubbs, if you want to be able to answer any piece of the

23 dollars, I would appreciate it.

24 DIRECTOR STUBBS: Sure. Thank you.

25 We do get, our Lead Hazard Control Program is a 80

1 3-year grant. We received $2.9 million, and that is with

2 respect to lead remediation. And then our clinical lead

3 prevention program is an annual grant, and we get about a

4 half a million dollars -- well, slightly more -- for that

5 grant.

6 REPRESENTATIVE WEBSTER: Yeah.

7 Mr. Chairman, I'll apologize ahead of time. I

8 didn't intend to be the environmental guy on the

9 Appropriations Committee, but here I am.

10 Secretary, should we be testing all of our

11 children, I mean, if the water is subject to that kind of

12 contamination?

13 ACTING SECRETARY BEAM: So, universal lead

14 testing is a legislative priority, and so yes, we hope to

15 partner with you and your colleagues in actually moving

16 this forward so that we can have children uniformly tested

17 for lead, and that's going to inform our studies and our

18 strategies that I just outlined before.

19 REPRESENTATIVE WEBSTER: Well, thank you for

20 saying that. It occurs to me that if we had those numbers,

21 it would create an urgency for us to create water quality

22 programs and infrastructure, you know, that we need across

23 Pennsylvania.

24 Thank you.

25 And, Mr. Chairman, that's the end of my 81

1 questions. Thanks.

2 MAJORITY CHAIRMAN SAYLOR: Our next questioner

3 will be Representative Dan Frankel.

4 REPRESENTATIVE FRANKEL: Thank you, Acting

5 Secretary. We really appreciate the opportunity today to

6 speak with you.

7 And I generally appreciate the many opportunities

8 that you have had with Members of the General Assembly,

9 meeting with us and with the Oversight Committee Chairs.

10 So I appreciate your availability so many times.

11 I would like to change the subject a little bit

12 here, and it was referred to briefly in the last

13 questioner, my colleague, and other colleagues today, and

14 that's the issue of our public health workforce

15 infrastructure.

16 You know, it's very clearly -- and this is a

17 national problem. It's not just something that we've done

18 here in Pennsylvania. But we clearly, over the last

19 several decades, disinvested from our public health

20 infrastructure, and a lot of that deals with the public

21 health workforce. And I think, you know, we're paying for

22 that now across the country and here in Pennsylvania, and

23 one of the things I was gratified to see within the budget

24 is about a 33-percent increase in funding for our county

25 and municipal health departments, which I think is an 82

1 important thing to do.

2 But I would like to talk to you a little bit,

3 and, I mean, I know we're focused on the crisis and the

4 pandemic at hand, but we need to be prepared for future

5 pandemics and other health crises, including water quality

6 and things like that that have reached really an

7 extraordinary urgency level, or levels of urgency.

8 So I want to ask you how you envision public

9 health. I mean, we are spending about $15 per capita today

10 for public health. Twenty-five years ago, we were spending

11 $30 per capita. Now, clearly we need to address this

12 issue, because this is not just this pandemic, it's a

13 future pandemic and other issues that are affecting public

14 health across the Commonwealth.

15 So I wonder if you can take a minute to talk

16 about, you know, what it means in this budget and what it

17 means down the road and how you envision us addressing, on

18 a long-term basis, how we rebuild our public health

19 infrastructure.

20 ACTING SECRETARY BEAM: Thank you so much.

21 So I'll speak first to our budget and go into a

22 little bit of vision. But I want to save time for Brian,

23 because we also have the entire plan that the Department

24 has coalesced around with really articulating our vision,

25 which will give a much more insightful and in-depth 83

1 response than I think we'll be able to provide at the

2 hearing today.

3 So first about public health planning right now.

4 So specifically speaking to the grant funding

5 that we have gotten from the Federal Government, we are

6 grateful for it. We know that it's going to give us the

7 opportunity to invest in some critical data management

8 systems that are part of that years and years of

9 underfunding that really lagged when we were trying to

10 actually run a response to a global pandemic relying upon

11 these systems.

12 And so we're going to not only be able to invest

13 in the underlying infrastructure but the right staff, and

14 so making sure that the Department of Health heroes that

15 have been able to respond for over a year at this point are

16 not the sole individuals whenever this next pandemic comes

17 and are responsible for actually being able to respond to

18 what that next pandemic is, because we know that bandwidth

19 right now is always an issue. We want to make sure that

20 our staff does not have that pandemic fatigue that so many

21 folks have, and to do that, we want to bring in the right

22 resources, bring in the right expertise, and really support

23 what exists as our infrastructure. It just needs

24 bolstered.

25 And so we're working on that specific to the 84

1 public health crisis, and we look forward to partnering

2 with the General Assembly as we do narrow in on any sort of

3 future budget requests or complement requests or the like.

4 With that being said, Director Lentes, do you

5 want to speak to the specific vision outlined in some of

6 our future-looking plans?

7 DIRECTOR LENTES: So in any good public health

8 practice, it is very important to make sure that the

9 infrastructure is in place. We have it clearly outlined,

10 and it is available on DOH's website for anyone to see.

11 It's the 3-year strategic plan, 2020 to 2023.

12 We feel that there are five core strategies that

13 would help us move forward, one of those being maintaining

14 and enhancing emergency services and public health

15 preparedness, a key perspective and aspect of any public

16 health department.

17 Two is continually develop our talents

18 significantly with public health. That is working with

19 OAHR in their resource and recruitment efforts.

20 Three is promoting public health awareness,

21 prevention, and improvement outcomes. So that is with our

22 public health programming.

23 And then in anything, using data measures,

24 evidence-based practices, and technology to enable high

25 performance. So that is encouraging the culture of 85

1 continuous quality improvement.

2 And fifth is really, and in finality, is to

3 improve staff, customer, and partner experience with

4 consistent and efficient and effective services. You may

5 be aware that the Governor has his transformation and

6 customer service initiatives in place, and that falls in

7 line with that.

8 With these five core strategies, we look to

9 improve our superstructure. We also continue to rely on

10 the Public Health Accreditation Board, which sets our

11 standards, and that is available to all public health

12 partners, including locals across the nation.

13 REPRESENTATIVE FRANKEL: Thank you.

14 Getting back to the present situation with, you

15 know, obviously we only have, our large counties and the

16 several municipalities have health departments. What

17 flexibilities do these local health departments have to

18 meet the needs of their regions for those many counties

19 that don't have their own health departments? And I just,

20 you know, would like to understand if they were able to

21 reach out and provide services to those other counties that

22 didn't have those resources.

23 ACTING SECRETARY BEAM: Sure.

24 So the structure of the county municipal health

25 department, and in statute, really creates what are 86

1 baseline responsibilities for those local jurisdiction

2 public health departments. So this is surveillance. But

3 also back to the environmental point from earlier, they are

4 also working to make sure that there is a localized effort

5 at doing that right response that we need. But there is a

6 lot of flexibility to allow our county municipal health

7 departments to tailor their investments and their

8 infrastructure to the needs of their local jurisdiction.

9 And so while the statute really sets out baseline

10 expectation that they have to be responsible for as an

11 entity, everything from food inspections and the like, it

12 allows them to truly know the needs of their community and

13 tailor their local jurisdiction health department

14 accordingly.

15 REPRESENTATIVE FRANKEL: Thank you very much.

16 Thank you, Mr. Chairman.

17 MAJORITY CHAIRMAN SAYLOR: Our next questioner is

18 Representative , Chairman of the Health

19 Committee.

20 REPRESENTATIVE RAPP: Thank you, Chairman Saylor.

21 Madam Secretary, thank you for being here, and

22 certainly we appreciated your testimony at the Health

23 Committee. So Chairman Frankel and I have heard much of

24 this questioning before, so I also will be speaking on or

25 questioning regarding another topic. 87

1 I know that you have had a lot on your plate

2 since being appointed to your position, but looking back at

3 the last year and the closings from the Governor and the

4 former Secretary, do you agree that closing our surgical

5 facilities and deeming certain surgeries unnecessary

6 procedures while citizens and their physicians and

7 specialists had no other alternative than to wait it out

8 until the Department of Health and the Governor said they

9 could reopen, as our citizens, many of them, waited in pain

10 until these facilities reopened, and while at the same time

11 abortion facilities were essential.

12 If we had another pandemic, do you believe that

13 you would follow that same closure of our surgical

14 facilities while allowing abortion facilities to stay open?

15 ACTING SECRETARY BEAM: So in the elective

16 procedures decision, I just want to make sure we also

17 remind ourselves that the entire underlying premise of that

18 was to make sure that our hospitals were not overrun. We

19 actually did that with close communication with a lot of

20 our hospitals, understanding what they were seeing from

21 their counterparts in other countries. And so when we were

22 able to actually move forward with the elective procedures

23 guidance, we do deem the reproductive services essential,

24 and so there was the differentiation between the essential

25 and the elective procedures at that time. 88

1 REPRESENTATIVE RAPP: Thank you, Madam Secretary.

2 Now, with the restaurant inspections, fines, and

3 court cases that we have seen over the last year, is your

4 staff doing any on-site inspections of abortion facilities,

5 or are you allowing all of your abortion facilities to

6 self-report?

7 ACTING SECRETARY BEAM: Sure.

8 So we actually had, as you indicated, we early in

9 the pandemic had really limited our on-site surveying

10 because of the risk that it posed to the staff, but we were

11 able to quite quickly, once we were through that initial

12 surge, adjust our surveying techniques to be able to have

13 more of those in-person surveys conducted.

14 Executive Deputy Klinepeter, do you have detail

15 on -- okay. So I think that the answer is, we moved to the

16 in-person surveys at this stage, and we have been able to

17 have, making sure that we are really focused on the

18 complaint surveys at issue and being able to be responsive

19 to those.

20 REPRESENTATIVE RAPP: Thank you. The last thing

21 we would like to see in Pennsylvania is a repeat of the

22 Gosnell situation.

23 And, Madam Secretary, for the Members and the

24 public, the Department of Health reported in the annual

25 report of the 2019 Abortion Statistics that 31,018 89

1 abortions occurred in Pennsylvania in 2019. That's future

2 little boys and girls for the State of Pennsylvania.

3 To put it in perspective, and I am in no way

4 trying to downplay the COVID deaths, because I do believe

5 that the COVID is real and that we definitely need to take

6 steps to protect our citizens. But as of Tuesday, there

7 were 23,711 deaths from COVID in 2020 compared to 31,018

8 abortions in 2019. There were four abortions performed on

9 young girls under the age of 12 -- and under, 12 and under.

10 What is the Department of Health's procedure regarding

11 follow-up of these types of cases, and there were 1,493

12 cases total of girls 18 and younger, including the previous

13 four.

14 So when we see in the Abortion Statistics, what

15 has the follow-up been from the agency in investigating the

16 abortions performed on these very young girls in our State

17 of Pennsylvania?

18 ACTING SECRETARY BEAM: Thank you,

19 Representative.

20 So as you noted, we are transparent with the

21 number of abortions that are performed in Pennsylvania, and

22 we are very -- we are not only issuing the quarterly

23 reports, we have the ITOP reports that come on an annual

24 basis.

25 I don't have the detail on the investigations or 90

1 the incidents, those specific incidences that you raised

2 right there, but I will be happy to have the team follow up

3 promptly with future detail that we can provide to you.

4 REPRESENTATIVE RAPP: Thank you.

5 And you mentioned the quarterly reports.

6 ACTING SECRETARY BEAM: Mm-hmm.

7 REPRESENTATIVE RAPP: In the Pennsylvania

8 Abortion Control Act, abortion providers have to file

9 quarterly reports with the Department of Health. So these

10 are available to the public after the Department reviews

11 the information at the Commonwealth Library. The

12 Commonwealth Library, however, has been closed throughout

13 the pandemic. How does one, someone from the public, gain

14 access to these reports that are required by statute to be

15 completed and available for inspection?

16 ACTING SECRETARY BEAM: Thanks, Representative.

17 So as you know, we still have the Annual Abortion

18 Report that we have issued timely. As for the actual

19 report with the State Library, I will follow up as to how

20 we can actually access those materials remotely during the

21 COVID pandemic.

22 REPRESENTATIVE RAPP: Thank you, because I do

23 believe one of my staff has requested those quarterly

24 reports. So if we could obtain those, that would be very

25 helpful and appreciative. 91

1 Thank you, Madam Secretary.

2 Mr. Chairman, thank you for allowing me time

3 today to ask these questions.

4 MAJORITY CHAIRMAN SAYLOR: Very good.

5 Madam Secretary, we are going to give you some

6 time, as well as ourselves some time today. We will

7 reconvene here at 1:30 to continue the questioning.

8 I want to thank you for your attendance this

9 morning and your patience with us, and we will see you at

10 around 1:30, Madam Secretary.

11 ACTING SECRETARY BEAM: Thank you.

12

13 (A break was taken.)

14

15 MAJORITY CHAIRMAN SAYLOR: We're going to get

16 started here.

17 Madam Secretary, are you ready to go?

18 ACTING SECRETARY BEAM: I believe so. Can you

19 hear me okay?

20 MAJORITY CHAIRMAN SAYLOR: Yes, we can. Thank

21 you.

22 We're going to start off with Representative

23 James, and we'll move through the list. Thank you.

24 REPRESENTATIVE JAMES: Thank you, Mr. Chairman.

25 Thank you, Secretary Beam. 92

1 I would like to deal today with a couple of

2 questions on program eliminations in the Governor's

3 proposed budget.

4 Now, there are 10 appropriations that have been

5 zero budgeted, and we have seen this before. Really, I

6 think now this is the sixth time, and hopefully most of us

7 in here will vote to restore them. But in the meantime,

8 let me give you a couple of examples: the diabetes

9 program, epilepsy support services, leukemia research. I

10 mean, these are all worthy reports to or I mean areas to

11 study. So that does save $12 million from the budget, but

12 I guess my question is, why are they being eliminated? Are

13 they not performing well?

14 ACTING SECRETARY BEAM: Thank you,

15 Representative.

16 And as you indicated, this is somewhat a pattern.

17 As you know, the Governor's proposed budget is really a

18 starting ground for discussions with the General Assembly,

19 and we will always work in good faith with the General

20 Assembly to ensure that there's a fair and equitable

21 Department budget that really does protect the health and

22 safety of Pennsylvanians.

23 REPRESENTATIVE JAMES: Okay. So you support

24 putting them back in, too.

25 Let me ask you a question, please, then. 93

1 Apparently, they fit in with your current mission, which is

2 a good thing. Would you agree that keeping these programs

3 in would improve the quality of life and promote good

4 health?

5 ACTING SECRETARY BEAM: So the Department of

6 Health's budget holistically has to be considered here, and

7 we anticipate that throughout this budget season, there

8 will be an opportunity for us to evaluate each of these

9 programs and work in conjunction with the General Assembly

10 to have a final budget product by the budget deadline that

11 will be reflective of those values.

12 REPRESENTATIVE JAMES: Okay. Well, and of course

13 while we're in a budget approval process, it's always wise

14 to consider many paths for responsible spending. But let

15 me ask you one other "would you agree" type question:

16 Eliminating these line items would result in poorer quality

17 of life and probably increased health-care costs.

18 ACTING SECRETARY BEAM: Thank you,

19 Representative.

20 So we anticipate engaging with you directly and

21 others of your colleagues on each of these issues where we

22 can evaluate the impact on the overall health of

23 Pennsylvanians to reach that final budget product.

24 REPRESENTATIVE JAMES: Okay. Thank you very

25 much. I'll be working to have them restored, and I hope 94

1 everyone in the room agrees with me.

2 Thank you, Mr. Chairman.

3 MAJORITY CHAIRMAN SAYLOR: Next is Representative

4 .

5 REPRESENTATIVE ECKER: Thank you, Mr. Chairman.

6 And thank you, Secretary Beam, for being here for

7 the afternoon as well.

8 So I'm going to shift gears back to nursing homes

9 and take an approach at looking again at the 650 -- so we

10 talked a little bit where we left off last, before lunch,

11 as we were looking at those 50 nursing facilities that

12 weren't part of the Federal program. I'm going to turn

13 back to the 650 that you are saying were part of that

14 Federal program. And your office and, you know, under your

15 direction, you have been committed to communication, and it

16 has been something that you have been focused on.

17 So in that regard, I think it's important that we

18 define what you and the Governor are referring to as

19 "nursing homes." Because I think some of the confusion

20 here that has arisen from announcing these milestones is

21 that when people associate nursing homes or residential

22 facilities, you know, assisted living facilities, they are

23 more than just a skilled nursing facility.

24 For example, in Adams County where I live,

25 there's a nursing home that is referred to as the 95

1 "Brethren Home," and everyone there knows this brethren

2 home, and there's a lot of components there. They have

3 residential living. They have skilled care living. They

4 have personal care facilities.

5 So my question to you, I guess first, would be,

6 how do you and the Governor define "nursing homes"?

7 ACTING SECRETARY BEAM: Absolutely.

8 So under the actual regulatory guidance, the

9 skilled nursing facilities are those that fall within the

10 Department of Health's purview. We also have the assisted

11 living residences and the personal care homes that actually

12 fall under the purview of the Department of Human Services.

13 And so we really go back to those originating licensure and

14 oversight statutes to define the separate entities that are

15 there.

16 REPRESENTATIVE ECKER: But you would agree that

17 your mission -- and when we're talking about our most

18 vulnerable populations, these folks all interact in these

19 facilities. So your mission as it pertains to nursing

20 facilities would be to really get these folks vaccinated,

21 all of these folks, whether or not they're in the

22 residential or in the skilled nursing care, to get those

23 folks vaccinated as quick as possible. Correct?

24 ACTING SECRETARY BEAM: So to be very clear, the

25 Federal Government, even in their guidance, said first and 96

1 foremost you need to have your skilled nursing facilities

2 vaccinated. They knew that the risks posed by the pandemic

3 and really those that were receiving care and the

4 vulnerability in their State meant that you first have the

5 skilled nursing facilities vaccinated. You follow through

6 with the assisted living residences, the personal care

7 homes, and then other congregate care settings, as we

8 outlined in our plan. But we really did, lessons learned

9 throughout the pandemic, that the skilled nursing

10 facilities were our most vulnerable areas, and so we

11 doubled down on making sure we committed to them as well.

12 And I do have the numbers from earlier that show

13 the demonstration and the dedication of each of our

14 allocations to the Federal Pharmacy Partnership week over

15 week, and I'm happy to go through them, if that would be

16 helpful.

17 REPRESENTATIVE ECKER: Well, you know, I think, I

18 guess my concern here is, what are you going to -- so the

19 Federal program was great, you know, and I'm glad that

20 we're celebrating milestones, but I don't want them to be

21 misconstrued here. We still got a lot of work to do, and I

22 guess my concern here is, how is the Department of Health

23 going to ensure that all of these facilities, these

24 communities, what's the plan to get those folks vaccinated

25 as fast as possible? 97

1 ACTING SECRETARY BEAM: Thank you, and this is

2 actually where my remarks came in on that same press

3 conference.

4 There is a lot of work to do. You're right. Our

5 assisting living residences and our personal care homes

6 need to have their first- and second-dose clinics first and

7 foremost completed. We're working on thirds for all of

8 them, but we want to make sure that they secure the same

9 type of success that we have had in the skilled nursing

10 facilities.

11 To date, we have been able to have roughly

12 30 percent of those assisted living residences and personal

13 care homes, the first dose is finished. With first doses,

14 there's 46 percent finished with CVS and there's 36 through

15 Walgreens. So we need to get that second-dose clinic to

16 get the full vaccine.

17 But more than that, for those entities that did

18 not qualify for the Federal Pharmacy Partnership, we then

19 created our own Pennsylvania safeguard with our Department

20 of Human Services and Rite Aid and worked in very close

21 partnership and said, look, the Federal Pharmacy

22 Partnership did not qualify you as an entity that could

23 actually have this program brought to you, but that doesn't

24 mean that we're going to have you left out in the cold.

25 Rather, we built a program in conjunction with DHS to go 98

1 out and reach these folks; again, allocating vaccine and

2 making sure that these facilities were able to access the

3 commodity that is necessary, but also supplemented with the

4 Rite Aid actually coming to these folks and holding those

5 clinics so that they didn't have to go and have those

6 residents moved to a brick-and-mortar pharmacy.

7 And so we are working these missions

8 simultaneously and as quickly as possible because of the

9 risks posed by those in congregate care settings.

10 REPRESENTATIVE ECKER: Well, and I appreciate

11 that, Secretary Beam, and I guess my word of caution here

12 is, you know, following that press conference, I did get

13 phone calls from those nursing home communities, not

14 necessarily from those skilled care folks, but I got calls

15 from those people that lived within the confines of that

16 residential community thinking, well, wait a second, the

17 Governor is saying we have vaccinated all of nursing homes,

18 but we didn't get the opportunity.

19 So I guess I just caution the messaging and make

20 sure that we are really celebrating milestones

21 appropriately so that we are not causing confusion and we

22 are communicating effectively and honestly with the

23 citizens of Pennsylvania.

24 Thank you for your time.

25 MAJORITY CHAIRMAN SAYLOR: Madam Secretary, I'm 99

1 going to give you, before I recognize Representative Cephas

2 as the next questioner, an opportunity to share the numbers

3 that you had gotten over the lunch hour.

4 ACTING SECRETARY BEAM: Absolutely, and thank you

5 for this opportunity.

6 So over 6 weeks, we really invested in that

7 Federal Pharmacy Partnership. So remember, we had to put

8 forward an initial investment before shots could even

9 happen. I feel that folks have already had me speak on

10 that point.

11 So for first doses, the week of 12/20, we

12 dedicated 56 percent of our first doses. The week of

13 12/27, 43 percent of our first doses went to this program.

14 The week of January 3rd, we had to start dedicating second

15 doses, so we did 56 percent of our first doses, 56 percent

16 of our second doses. 1/17, we did 56 percent of our first

17 doses, 43 percent of our second doses. 1/24, we did

18 63 percent of our first doses and 56 percent of our second

19 doses. And the last week was 1/31. We did 63 percent of

20 our first doses and 64 percent of our second doses went to

21 the Federal Pharmacy Partnership to fulfill our mission of

22 getting these long-term care facilities vaccinated as

23 quickly as possible.

24 MAJORITY CHAIRMAN SAYLOR: Very good.

25 With that, we'll move to Representative Cephas. 100

1 REPRESENTATIVE CEPHAS: Thank you, Chairman, and

2 good afternoon, Secretary.

3 ACTING SECRETARY BEAM: Good afternoon.

4 REPRESENTATIVE CEPHAS: I want to talk a little

5 bit about the issue of maternal mortality. So as you know,

6 how we define "maternal mortality" is when an individual

7 loses their life due to their pregnancy either while

8 they're pregnant or during up to a year postpartum.

9 You know it has been a national conversation.

10 Our rates continue to increase across the nation,

11 especially here in the Commonwealth. You just recently

12 released a report about pregnancy-associated deaths where

13 we have seen a 21-percent increase in maternal mortality

14 deaths. Additionally, you saw 40 percent in 2018 of those

15 deaths related to accidental poisoning, which includes drug

16 overdoses.

17 Now, considering that our trends were going in

18 the wrong direction prior to COVID-19, adding in a pandemic

19 to that equation is extremely concerning and extremely

20 alarming.

21 I know as a Commonwealth we have made some

22 significant strides, including the creation of a Maternal

23 Mortality Review Committee. We have made significant

24 financial investments in our health-care systems, and a

25 significant number of our network providers have been 101

1 laser-focused on reversing these trends.

2 Can you talk to me about what your Department is

3 doing to address this issue and to hopefully take it into a

4 different direction?

5 ACTING SECRETARY BEAM: Absolutely. Thank you

6 for this question. It's important to highlight this as,

7 again, that steady drumbeat of programs that we have to

8 keep running while responding to the global pandemic.

9 With that being said, the Maternal Mortality

10 Review Committee absolutely reviews these deaths in a

11 de-identified way but allows there to be a comprehensive

12 analysis of the death, and then, most importantly, the team

13 comes up with preventable solutions of how to prevent that

14 same death from happening over again. That's the

15 comprehensive report that we released.

16 I do just want to highlight, there's an equity

17 angle here as well, because we also know that the maternal

18 mortality rate is very different by way of different race

19 mothers, and that is again a more compelling reason to us

20 to get back to that underlying value of having communities

21 that have those disparate health equities be able to find

22 more balance in the society that we are building

23 post-pandemic.

24 But in addition to the Maternal Mortality Review

25 Committee, we also have the Perinatal Quality 102

1 Collaborative, which is where we're actually working with a

2 lot of providers to make sure that they know best practices

3 and are able to really get the prenatal care that is

4 necessary for the healthy mother and the healthy baby.

5 REPRESENTATIVE CEPHAS: I appreciate that

6 response, and I appreciate all the work that you are doing.

7 Continuing this conversation, again, when you add

8 COVID-19 to this dynamic, again, we're going to see a

9 significant number of increases as it relates to maternal

10 deaths. Has there been any conversation around

11 prioritizing pregnant and birthing people as it relates to

12 your plans for vaccination?

13 There have been studies that have shown that

14 pregnant and birthing people experience COVID-19 at a

15 higher rate, and they are going into our ICUs at a higher

16 rate as well. Is there any thought on prioritizing this

17 population as, again, we move through this pandemic?

18 ACTING SECRETARY BEAM: Yeah. So, pregnancy is

19 one of the conditions in 1A, and so when we have been

20 talking about the expansion of 1A, it' s 65 and older, but

21 it also is 64 and under with certain conditions, and

22 pregnancy is one of them.

23 Executive Deputy Klinepeter, did you want to add

24 to that?

25 EXECUTIVE DEPUTY SECRETARY KLINEPETER: I think 103

1 that we have certainly prioritized individuals who are in

2 labor (audio malfunction).

3 Can you hear me?

4 REPRESENTATIVE CEPHAS: We can barely hear you.

5 EXECUTIVE DEPUTY SECRETARY KLINEPETER: I'll try

6 one more time.

7 REPRESENTATIVE CEPHAS: Okay.

8 EXECUTIVE DEPUTY SECRETARY KLINEPETER: Can you

9 hear me now?

10 REPRESENTATIVE CEPHAS: Yes.

11 EXECUTIVE DEPUTY SECRETARY KLINEPETER: Great.

12 Sorry for the technical difficulties.

13 I just wanted to highlight that while we have

14 certainly prioritized pregnant individuals in our

15 vaccination plan, we have also prioritized laboring

16 patients over the course of the pandemic for our hospital

17 guidance, which specifically calls out that individuals who

18 are laboring patients should be allowed to have someone by

19 the bedside with them, including a doula. So that has

20 certainly been a priority for the Department over the

21 course of the pandemic.

22 REPRESENTATIVE CEPHAS: I appreciate that, and I

23 recognize that in New York, they were attempting to limit

24 individuals from having support at the hospital bed during

25 their birthing process, so I appreciate that Pennsylvania 104

1 went into a different direction when it comes to that

2 issue.

3 But again, as we move through COVID-19, with the

4 added pressures to pregnant individuals, we just need to

5 make sure that we are prioritizing maternal health during

6 this process.

7 So again, I thank you for all that you are doing,

8 and if we can just stay diligent on this issue, that would

9 be great.

10 ACTING SECRETARY BEAM: Thank you.

11 MAJORITY CHAIRMAN SAYLOR: Next is Representative

12 Fritz.

13 REPRESENTATIVE FRITZ: Thank you, Chairman

14 Saylor.

15 And good morning, or rather good afternoon,

16 Madam Secretary. Thank you for joining.

17 Madam Secretary, I am interested in talking about

18 your Department's express desire to study the health

19 effects of hydraulic fracturing, or fracking.

20 In 2019, the Department of Health announced it

21 was committing several million dollars over the next

22 several years for a fracking study. Now, Madam Secretary,

23 despite not receiving the requested funds for a study, the

24 Department and the Administration in December 2020

25 announced a $2.5 million contract with the University of 105

1 Pittsburgh for two different studies on fracking.

2 Now, Madam Secretary, I have been honored to

3 serve on the House Appropriations Committee for several

4 years, and I'll mention that year after year, it has

5 realized that outside money from special interest

6 organizations works its way into our Pennsylvania budget.

7 So please share with us how this study and continuing

8 studies will be funded if the enacted budget did not

9 include said requested dollars.

10 ACTING SECRETARY BEAM: Thank you,

11 Representative.

12 And before turning it over to Director Stubbs, I

13 will just offer that you are right, there are two studies

14 underway to understand the impacts of fracking in the

15 Commonwealth, one oriented towards childhood cancer and one

16 more oriented towards acute health outcomes, and the

17 University of Pittsburgh is working as our partner in these

18 studies.

19 Director Stubbs, do you want to speak to the

20 dollar question specifically?

21 DIRECTOR STUBBS: Yes. Thank you.

22 And the fracking study was to occur over three

23 State fiscal years -- the current year, which of course is

24 2021; the budget year, which is '21-22; and then finish up

25 in '22-23, I believe by December of that year. 106

1 For the first year, which is this year, we are

2 actually using prior-year waiver funds to fund this study.

3 And for the next State fiscal year, there is a total of

4 $1.3 million in the Governor's recommended budget to cover

5 this study, and the anticipation is that in the third and

6 final year, money will also be included in the budget to

7 complete this study.

8 REPRESENTATIVE FRITZ: Okay. Thank you for

9 clarifying.

10 Madam Secretary, are there particular health

11 impacts that are being targeted, and will such a study

12 possibly reveal and substantiate that Pennsylvania is

13 actually benefiting from cleaner air and cleaner water?

14 ACTING SECRETARY BEAM: So the particular

15 studies, the first study is going to focus on childhood

16 cancers of the Ewing family of tumors in the southwestern

17 area of Pennsylvania using a case control study approach,

18 and the second study is going to involve the association

19 between acute health effects such as asthma and adverse

20 birth outcomes and the exposure to fracking.

21 Executive Deputy Secretary Klinepeter?

22 EXECUTIVE DEPUTY SECRETARY KLINEPETER: Thank

23 you, Acting Secretary.

24 So to date, the strongest published evidence for

25 adverse impacts are related to decreased birth weight, 107

1 preterm birth, and small gestational age effects, as well

2 as asthma. However, the birth outcomes, there have been

3 few recent studies that show an effect. The DOH will

4 continue to monitor this and evaluate this published

5 literature.

6 REPRESENTATIVE FRITZ: Okay. So voices are a

7 little muffled here, but I think I caught most of that

8 response. But my takeaway is that this study is crafted to

9 examine only perceived negative health impacts, and I just

10 wanted to mention that thanks to the transfer to natural

11 gas as a feedstock for energy generation and the cleaner

12 emissions, we actually have cleaner air. And we have

13 reports out of Penn State and actually DEP, as well as the

14 Susquehanna River Basin, that we have cleaner water as

15 well, and I think that's important to note.

16 Continuing on that theme.

17 Madam Secretary, you have an impressive resume

18 and have been a principal within the PA Department of

19 Health for some time. That said, have you seen any

20 widespread health impacts resulting from a particular

21 industry in Pennsylvania, and really where I'm going is

22 this: Should we be seeking use of taxpayer dollars chasing

23 ghosts?

24 ACTING SECRETARY BEAM: Thank you,

25 Representative. 108

1 I just wanted to clarify, the duration at the

2 Department has been for 4 ^ weeks, and I believe that I

3 would want to defer to the team to have any sort of

4 historic knowledge of where they have had observations that

5 you are asking about.

6 REPRESENTATIVE FRITZ: Okay. Thank you. Thank

7 you. I'm going to end with a thought, and you can circle

8 back to me, Madam Secretary. But just a thought here.

9 Has your Department considered conducting a study

10 on the mental health impacts of the unrelenting scare

11 tactics and sensationalism that Pennsylvanians experience?

12 I appreciate the time and the interrogation.

13 Mr. Chairman, that's all.

14 MAJORITY CHAIRMAN SAYLOR: Our next questioner is

15 Representative Brown from Philadelphia.

16 REPRESENTATIVE A. BROWN: Good afternoon,

17 Madam Secretary.

18 ACTING SECRETARY BEAM: Good afternoon.

19 REPRESENTATIVE A. BROWN: Thank you,

20 Mr. Chairman.

21 Pennsylvania suffers close to 1600 gun deaths

22 each year, whether by homicide, suicide, or unintentional

23 shootings. PA is one of a growing number of States where

24 we have more gun deaths than deaths due to automobile

25 accidents. How much money is allocated from the Department 109

1 of Health's budget to address gun violence in Pennsylvania?

2 ACTING SECRETARY BEAM: So first, I just wanted

3 to thank you for bringing up this important topic. As you

4 know, this was an issue that we have worked on not only

5 from the Governor's Office but now specifically within the

6 Department of Health, especially with the creation of the

7 division of violence prevention. We have been able to

8 actually invest in making sure that the Department of

9 Health and also through its violence prevention dashboard

10 is contributing to how we are going to strategically

11 address this issue, as challenging as it is, even in a

12 pandemic.

13 Specifically to the dollars, I will ask

14 Director Stubbs to aid in actually enumerating any dollars.

15 But I know this is, again, an issue that we have been able

16 to actually stay invested in despite the global pandemic,

17 and I think that's a true dedication to the Governor's

18 dedication to making sure that gun violence is addressed

19 under his Administration.

20 Director Stubbs?

21 DIRECTOR STUBBS: Yes. We fund, for the most

22 part, the violence prevention activities with the grant

23 from the National Violent Death Registration System and

24 also through our Preventive Health and Health Services

25 Block Grant. 110

1 REPRESENTATIVE A. BROWN: So did you say a dollar

2 amount? I don't know if I heard.

3 DIRECTOR STUBBS: I don't have a dollar amount in

4 front of me, but I would be happy to follow up with it.

5 REPRESENTATIVE A. BROWN: Okay. Thank you.

6 My next question is, what does the Department

7 plan on doing with information gathered from the Violence

8 Dashboard created by Governor Wolf's Executive Order?

9 ACTING SECRETARY BEAM: Yeah. So part of

10 informing our strategy and really getting our hands around

11 gun violence, which is a very difficult topic at times, the

12 Violence Data Dashboard is actually to have a better

13 understanding of the scope, the frequency, the geography,

14 and the populations that really are affected by violence,

15 including the counts and the rates and the factors

16 contributing to violence.

17 When the Governor was really investing in the

18 efforts around gun violence, one of the things that we knew

19 we needed more of was information to strategically design

20 our approach to combating gun violence. And so the

21 Violence Data Dashboard is not only us as an Administration

22 collecting information, but we're also sharing it. I think

23 folks know this Governor's dedication to transparency. And

24 so any information that we had to address the issue, we

25 wanted to make sure to share it with the general public. 111

1 Those counts include accrued counts for

2 age-adjusted rates for assaults, self-harm attempts,

3 suicide by firearms, cuts, piercings, and poisonings. All

4 of this helps understand the presence of violence in our

5 society and then allows us to really hone in on gun

6 violence and then strategize on how to address it.

7 REPRESENTATIVE A. BROWN: Thank you.

8 So based on information from the Department's

9 website, as of December 2020, the Pennsylvania Violent

10 Death Reporting System program receives data from coroners

11 and medical examiners in 34 counties and law enforcement

12 agencies from 14 counties. Do you know why the additional

13 33 counties, 33 county medical examiners and 53 law

14 enforcement agencies, are not providing the Department with

15 this same information?

16 ACTING SECRETARY BEAM: So we work to actually -­

17 we hope to be in close collaboration with our coroners and

18 our medical examiners on building out this data sharing. I

19 think it's evident how important it is to make sure that

20 our strategies aren't only viewed and based on data of that

21 limited aspect, which you already articulated right now

22 what the current contributing data factors are. And so

23 this is, again, an opportunity where we can more closely

24 work with the medical examiners and the coroners to have

25 better data reporting and then have a more comprehensive 112

1 dashboard.

2 REPRESENTATIVE A. BROWN: Okay. I would greatly

3 appreciate some follow-up with that.

4 And then my last question. Do you have any

5 suggestions about what we can do as Legislators to address

6 gun violence more effectively from a public health crisis

7 perspective? A public health perspective; sorry.

8 ACTING SECRETARY BEAM: So, you know, we have a

9 lot of ideas on how we can actually use public health and

10 gun violence together.

11 We know that at its fundamental essence, gun

12 violence and the presence of violence in someone's life is

13 a social determinant of health, and so how do we allow

14 folks, realizing how much social determinants of health

15 play into one's physical health but also mental health, how

16 do we as an Administration or collectively as leadership

17 within the Commonwealth work to address it?

18 The Governor's Executive Order back in 2019

19 really outlined a few key areas, even with things like the

20 Suicide Prevention Task Force, that we knew that we needed

21 to address. But I think that what we would hope for is

22 that the report that actually came out of the Special

23 Committee on Gun Violence, those discrete recommendations

24 can now be acted upon and hopefully even more invested in,

25 especially from the Department of Health's perspective, 113

1 once we have the COVID-19 pandemic a bit more under

2 control.

3 REPRESENTATIVE A. BROWN: All right. Thank you,

4 Madam Secretary.

5 Thank you, Chairman.

6 MAJORITY CHAIRMAN SAYLOR: Representative

7 Doyle Heffley.

8 REPRESENTATIVE HEFFLEY: Thank you, Mr. Chairman,

9 and thank you, Madam Secretary.

10 I want to bring this back a little bit, back to

11 the vaccine rollout and some of the comments you made

12 earlier, lessons learned, and we know there were mistakes

13 made earlier by sending COVID-positive patients into

14 nursing homes that were ill-equipped to handle it and were

15 not provided the PPE by the Department to do that.

16 But aside from that, one of the things that I

17 found concerning was last week during the testimony,

18 Secretary Wetzel had stated that inmates and staff at the

19 Department's three 1A facilities had begun to receive their

20 vaccines. And my question is, what pool of vaccines do

21 those administered to the inmates come from? Are we taking

22 -- I mean, obviously we have heard from Members on both

23 sides of the aisle the concern that senior citizens and

24 folks in their communities, schoolteachers, can't get the

25 vaccine, but yet we're pulling from that pool of vaccines 114

1 to inoculate inmates.

2 And just a side note is, one of the things that

3 the Secretary stated last week is that in the long-term

4 care facilities run by the Department of Corrections, the

5 mortality rate was nine times lower. So you were much more

6 inclined to survive COVID if you were in a corrections

7 facility than if you were in a long-term care facility. So

8 why would we then be prioritizing those inmates, and where

9 did those vaccines come from?

10 ACTING SECRETARY BEAM: Yeah. Thank you,

11 Representative.

12 So we worked with the Department of Corrections,

13 because as you all know, the Department of Corrections does

14 have three facilities that are long-term care facilities.

15 And insofar as our plan allowed phase 1A to have long-term

16 care facility residents and staff be vaccinated, we worked

17 to make sure that we were also reaching the populations

18 that staff and that are residents of those long-term care

19 facilities. We know that that is a significant

20 vulnerability across the board, and we---

21 REPRESENTATIVE HEFFLEY: But the general

22 population, the general population and the corrections

23 officers haven't been vaccinated yet, and, you know, folks

24 that are in those facilities, they can be isolated. That's

25 why they're there, obviously, because, you know, a lot of 115

1 folks that are in long-term care facilities in nursing

2 homes had to be pretty much isolated because the sick

3 patients were put in their hospitals. So why are we

4 prioritizing those folks over others, because we didn't get

5 to all the 1A yet. There's still a lot of people lined up,

6 calling. They call my office. I have heard from many

7 Members here about the frustration in getting the vaccine.

8 It just doesn't make sense why we're going to prioritize

9 inmates in our State correctional facilities and get those

10 vaccines to them before corrections officers,

11 schoolteachers, senior citizens.

12 And we know that there's still a lot of nursing

13 homes that weren't in the Federal program that are still

14 waiting to get those vaccines. Why can't we prioritize

15 them first, and do you think it' s appropriate that teachers

16 and corrections officers and senior citizens that work and

17 live in the State of Pennsylvania should be secondary to

18 consideration for the vaccine above inmates in our State

19 correctional institutions?

20 ACTING SECRETARY BEAM: So we have been

21 abundantly transparent that our long-term care facilities

22 have been a vulnerability throughout this entire COVID-19

23 response. They are our focus. And so these are our

24 long-term care facilities that actually are part of our

25 corrections institutions, but they are nonetheless 116

1 long-term care facilities, which we have stayed dedicated

2 to, and especially when it came to the vaccine rollout

3 having skilled nursing facilities, residents and staff, be

4 first and foremost to prevent any future death -- any

5 future death.

6 REPRESENTATIVE HEFFLEY: But those corrections

7 facilities were put ahead of other facilities. So I don't

8 -- I understand your ideology or your opinion on that, but

9 I can tell you that I'm hearing from a lot of folks that

10 don't agree with that, and I'm hearing from a lot of folks

11 that are trying to get the vaccine, schoolteachers who want

12 to get kids back at school. And the whole thing with the

13 vaccine rollout is to get our economy open as we get herd

14 immunity, and these folks aren't going to be participating

15 in the economy. I just don't understand why the Department

16 of Health would prioritize that when we have not

17 prioritized other folks to get the vaccine. And there has

18 been confusion, and just a lot of folks are really dismayed

19 at the priorities of this Department of Health.

20 ACTING SECRETARY BEAM: We have had a singular

21 priority this entire response, which is to save lives, and

22 to save lives, we needed to make sure that those that were

23 in our skilled nursing facilities, whether they be part of

24 the correctional institutions or not, were prioritized in

25 the vaccine rollout. 117

1 REPRESENTATIVE HEFFLEY: But the mortality rates

2 in those facilities was nine times lower than in other

3 facilities. Why wouldn't we prioritize the facilities with

4 the higher mortality rate?

5 ACTING SECRETARY BEAM: So--

6 REPRESENTATIVE HEFFLEY: That doesn't -- I don't

7 really get that. I mean, there are still people out there

8 that are much more vulnerable right now that are waiting

9 for the vaccine and can't get the vaccine, or had an

10 appointment and had to have it rescheduled because of the

11 100,000 dose mess up there.

12 I just don't understand why we're not

13 prioritizing taxpaying citizens, the working citizens, the

14 senior citizens of this community, the schoolteachers,

15 before inmates in our prison system.

16 ACTING SECRETARY BEAM: So we are working

17 tirelessly to get to the teachers and the frontline workers

18 that more broadly need to have access to the vaccine.

19 There is no arguing against that.

20 With that being said, we knew that the greatest

21 risk of COVID spread and COVID death is in our long-term

22 care facilities, including correctional facilities that are

23 long-term care facilities in essence. And so we dedicated

24 the vaccine for those three facilities to be able to

25 vaccinate not only their staff but also the residents who 118

1 are frontline workers who are actually serving those

2 residents right now to make sure that they could get

3 vaccinated as well.

4 REPRESENTATIVE HEFFLEY: Just one follow-up.

5 There was an article in the newspaper about

6 corrections officers not getting the vaccine but a plan to

7 pay inmates $25 to get the vaccine. Is that true, and why

8 would we be paying inmates to get the vaccine before and

9 putting them once again ahead of the folks that aren't in

10 prison to get the vaccine?

11 ACTING SECRETARY BEAM: I am not aware of that

12 plan, but I'm happy to follow up once the team -- if you

13 want to send the article, the team can follow up, too.

14 REPRESENTATIVE HEFFLEY: Thank you.

15 ACTING SECRETARY BEAM: Mm-hmm.

16 MAJORITY CHAIRMAN SAYLOR: Next is Representative

17 Rothman.

18 REPRESENTATIVE ROTHMAN: Thank you, Secretary

19 Beam. Thank you for being here today.

20 And I want to ask you a couple of questions about

21 the vaccination plan specifically, and we're relying on

22 newspaper articles. But there have been several articles

23 that talk about health systems are vaccinating all

24 employees, including, in some cases, billing clerks,

25 administrators, and in one case even an employee who was 119

1 responsible for doing fundraising working from home, and

2 that these employees don't have direct contact with the

3 patients or even have underlying health conditions.

4 There was a comment by Dr. Braund, who said, but

5 the bottom line is, there is no order that compels

6 hospitals to abide by your Department's plan. I just

7 wanted to ask you, is there something we are doing to make

8 sure that the health systems are abiding by your

9 vaccination plan, and is there proper oversight of who is

10 receiving the vaccinations and are we making sure that they

11 are legitimately eligible?

12 There was also, along those same lines, there was

13 a story in Philadelphia about Fighting Philadelphia where

14 the director, who is a 22-year-old, was giving vaccinations

15 to his friends. And I understand that the Department of

16 Health doesn't have direct oversight over the Philly plan,

17 but what are we doing to make sure that we're not wasting

18 these vaccinations on people who aren't legitimately in

19 line for them?

20 ACTING SECRETARY BEAM: Thank you for that.

21 And so the number-one action that we have taken

22 to address this is specific to accountability of our

23 provider network. I think I had mentioned in this

24 morning's testimony, we are grateful for the over 1800

25 providers who want to step up and be our vaccinators, but 120

1 we also know that there needs to be accountability so that

2 we can hone in and refine that provider network to those

3 that are abiding by our plan, those that are getting first

4 doses out urgently, those that are turning around reporting

5 within 24 hours. Those are critical responsibilities that

6 the providers actually are going to shoulder, and we are

7 grateful for their partnership in it, but that order was

8 truly us holding them accountable, because they are going

9 to be able to allow us to have more of a successful rollout

10 strategy moving forward.

11 Executive Deputy Klinepeter, do you have

12 something to add?

13 EXECUTIVE DEPUTY SECRETARY KLINEPETER: We also

14 issued an order previously that detailed that 10 percent of

15 the vaccine going to hospitals should be used on

16 nonaffiliated providers, and in that order I believe that

17 we did also detail the specifics of who within the health

18 system should be vaccinated. We are pleased to follow up

19 with you with that order.

20 REPRESENTATIVE ROTHMAN: So you would agree that

21 a fundraiser, I think in their early 30s who is working

22 from home, wouldn't be included in that definition, though.

23 I think that's what concerns people. But does the

24 Department of Health have the authority to make the

25 hospitals comply with the orders? 121

1 ACTING SECRETARY BEAM: Yes.

2 The February 12th order that was issued that

3 outlined that they needed to, the providers needed to abide

4 by our phases as a Commonwealth, we do have authority under

5 that order to make sure that providers are abiding by our

6 phased rollout plan, which is how we have structured this

7 in Pennsylvania.

8 REPRESENTATIVE ROTHMAN: Good. Well, thank you

9 very much, and I thank you for your time today. And I wish

10 you well and wish you luck in your new position.

11 ACTING SECRETARY BEAM: Thank you.

12 MAJORITY CHAIRMAN SAYLOR: Next is Representative

13 Greiner.

14 REPRESENTATIVE GREINER: Thank you, Mr. Chairman,

15 and thank you, Madam Secretary, for being here.

16 This has been, for all of us, a very trying time.

17 I know we talked about the vaccines. I want to go back to

18 last year, though, and I actually have a problem with it

19 now. Partly, this is the Federal level in the State, but I

20 don't think this Administration has been forthcoming at all

21 with how COVID response decisions are made.

22 And, well, I think the biggest thing for me is

23 the underlying science: Wear these masks. Most people in

24 my district are going to wear them, but I think there's a

25 supermajority of them who don't understand why they are and 122

1 whether it really makes a difference. That's just one

2 example.

3 Of course, we have kids that want to play sports

4 and they're told they have to wear masks, then they don't

5 have to wear masks. And Dr. Fauci said we don't need to

6 wear masks, then we need to wear masks, now we need to wear

7 two masks, and it just keeps on going on and on. Nobody

8 knows what the science is. We don't have the data. The

9 people in this State are confused.

10 And I think we need to have -- and the press

11 conferences early on I thought were contrived that we had

12 here in this Commonwealth, and I think people want to know

13 the facts. They want to know the truth. Whether it's the

14 Federal level or the State level, we need to get that out

15 there.

16 And I guess what I also want to know is, which

17 experts? Who are we listening to? Early on when we had

18 our business closures, the Department of Health is the one

19 that shut businesses down. We weren't even following CDC

20 guidelines. We were following guidelines that were even

21 stricter, the construction industry and stuff. And they

22 were saying, well, DCED said we're listening to the

23 Department of Health, and it was just -- I mean, we have

24 heard this story in these hearings.

25 So I do have a -- I'm just speaking from the way 123

1 I know a lot of my constituents feel and I think a lot of

2 people here in the Commonwealth. And I do know, though,

3 that the Federal Government had provided the Department of

4 Health a billion dollars to respond to COVID -- a billion

5 dollars, the last Administration. And I would like to know

6 what the Department of Health did with that $1 billion.

7 My understanding is the Department of Health did

8 hire somebody or contract with additional scientists. As a

9 matter of fact, I think there might be one here today at

10 this hearing. But what have you done with all that money,

11 and what are you planning to do moving forward as we try to

12 deal with this once it is? We all get this. It's a once

13 in a century pandemic, so what are you doing moving

14 forward? What did you do with that $1 billion?

15 ACTING SECRETARY BEAM: Thank you,

16 Representative, and I'll just jump into what did we do with

17 the dollars. I'm happy to take time to discuss the mask

18 issue or anything like that, but I have been advised to

19 stay concise and so I'm going to try and do so.

20 So the 1.18 billion has been awarded in multiple

21 grant programs, and I do just want to caution, and

22 Director Stubbs, if you have the breakdown, we have not

23 received all of that dollars. I just want to make sure

24 that folks know that a considerable portion of it has been

25 awarded, but we are still submitting our budget to the 124

1 Federal Government for not only I believe the 645 million

2 ELC grant but then also for the 101 million vaccine grant.

3 And so just tempering expectations, we did have

4 this come in increments from last spring, but we have not

5 received a majority of these dollars yet. But of that that

6 we have received, there is four primary areas: the public

7 health emergency preparedness to make sure that we were

8 prepared as far as we could be with our hospitals and the

9 like; making sure that there was hospital preparedness; the

10 epidemiology and laboratory capacity, or ELC as I was

11 calling it earlier; and the immunization and vaccines for

12 children. Those were the four primary channels for getting

13 those grant dollars to us.

14 Underneath those, the budgets really break out

15 exactly how we invested in here. So a majority was -- oh,

16 not a majority of the entirety. But of the ELC grant that

17 we first received, part of it went to our county and

18 municipal health departments. About a third of it did.

19 We did targeted and long-term testing. All the

20 testing efforts that we have been talking about whereby we

21 bring testing into your communities, that was paid for by

22 these grants.

23 We have had personnel investments so that we

24 could actually have a bench of folks here to be able to

25 advise, strategize, and respond to the pandemic. 125

1 We also have contact tracing and IT staff, which

2 we have been having a lot of discussions with the

3 Legislature about contact tracing and the utility of it to

4 make sure that we can very closely have a case

5 investigation followed by the necessary contact tracing.

6 We have also invested in our lab.

7 We have had mobile upgrades in the epidemiology

8 and immunization data systems, along with communication---

9 REPRESENTATIVE GREINER: I'm running out of time.

10 Can you please send the Committee a summary of

11 that, please, for us to review, send the Chairman so the

12 Members can see that breakdown.

13 And then before I -- going back to my original

14 statement, though, I want to know what professional

15 expertise you used to lock down this State, to shut down

16 this State with these business closures. Who did we use,

17 and what authority did we have? What scientific background

18 did we have to be able to do what we did in this

19 Commonwealth?

20 Thank you.

21 ACTING SECRETARY BEAM: So at that stage, we have

22 a very deep team of epidemiologists that we rely on to make

23 sure that we are as prepared as possible, but we are also

24 using folks that were from the universities and

25 institutions throughout Pennsylvania to help us understand 126

1 the ramifications of business closure decisions and the

2 like. And so we used both internal and external resources

3 to inform those decisions.

4 MAJORITY CHAIRMAN SAYLOR: Our next questioner is

5 Representative Warner.

6 REPRESENTATIVE WARNER: Thank you, Mr. Chairman.

7 Thank you, Madam Secretary, for joining us here

8 today.

9 A line of questioning revolving around

10 registering for vaccines and the vaccine itself. So I just

11 first want to know, when was the Department and the

12 Governor first notified about the potential of a COVID-19

13 vaccine being available?

14 ACTING SECRETARY BEAM: So I will check to get a

15 date certain to you. I think that we knew that they were

16 in development from the Federal Government's indications to

17 us through Operation Warp Speed. However, there was

18 tremendous amounts of speculation that were put into the

19 timeframe for actually when those potential vaccines could

20 come to fruition.

21 REPRESENTATIVE WARNER: Okay. So when would you

22 say the general public had an idea? I mean, I remember

23 seeing some stories last summer that different vaccines

24 were made available. Would you say that that's a safe bet,

25 to say that we knew last summer that vaccines would be 127

1 coming?

2 ACTING SECRETARY BEAM: So I believe we remained

3 hopeful. There was a significant investment from the

4 Federal Government in five specific companies to have their

5 vaccines created, and we also had Pfizer, which was not

6 part of Operation Warp Speed.

7 REPRESENTATIVE WARNER: But we did know at some

8 point that vaccines would be readily available to fight

9 this pandemic, correct? And there were different, there

10 were different vaccines that were being researched. But we

11 knew at some time that vaccines would be available to treat

12 this pandemic, correct?

13 ACTING SECRETARY BEAM: I think that's a fair

14 assumption that at some---

15 REPRESENTATIVE WARNER: Okay.

16 ACTING SECRETARY BEAM: Okay. We were very

17 helpful the vaccine would be there.

18 REPRESENTATIVE WARNER: Okay. So when did

19 Pennsylvania first receive vaccines?

20 ACTING SECRETARY BEAM: Pennsylvania first

21 received vaccines I believe December 14th.

22 REPRESENTATIVE WARNER: December 14th. Okay.

23 So last year, we knew that a vaccine was coming.

24 December 14th, we received vaccines. When was the

25 Legislative COVID Vaccine Task Force created? 128

1 ACTING SECRETARY BEAM: I believe 3 weeks ago.

2 REPRESENTATIVE WARNER: Okay, 3 weeks ago. We

3 knew about this vaccine probably over a year ago. We

4 suggested, we suggested a working group like the one just

5 created back in March. Is that correct? Are you aware of

6 the efforts for this body to create a task force like the

7 one that is created now?

8 ACTING SECRETARY BEAM: I was not made aware---

9 REPRESENTATIVE WARNER: Okay.

10 ACTING SECRETARY BEAM: ---that there was a

11 Legislative Task Force that--

12 REPRESENTATIVE WARNER: I just want to note that

13 there was, last spring that we tried to create one.

14 The point being here is that to me, it's a little

15 disappointing to see how behind the ball we are with this

16 vaccine when we were aware of it a year ago. I mean, if

17 there is one top priority for the Governor or for this

18 Department, it should have been having an organized vaccine

19 rollout.

20 We can talk about whatever we want, but the

21 number-one thing to put an end to this pandemic would be a

22 vaccine, and it seems like we put the least amount of

23 effort into how this is going to be rolled out. Instead,

24 we put more time and effort into whether someone can sit at

25 a barstool or not or whether they had to sit back at a 129

1 table.

2 So my next questioning is, you know, if someone

3 wanted to register for a vaccine, give me a very brief

4 rundown of what you would tell them. Someone brand new,

5 just moved to the State, doesn't know anything about it:

6 I want a vaccine; what should I do? How do I register?

7 ACTING SECRETARY BEAM: So on the heels of your

8 last comment, I would just offer that there was

9 ever-changing Federal guidance on what the State's role

10 would be on the vaccine, which continues to evolve, which

11 makes it difficult.

12 REPRESENTATIVE WARNER: I understand, but we

13 should have had an organized group planning for what we

14 were going to do, correct? Would you not agree with that?

15 ACTING SECRETARY BEAM: We did. We had a Vaccine

16 Task Force that was working---

17 REPRESENTATIVE WARNER: You just told me that the

18 Vaccine Task Force was created a few weeks ago. I'm

19 talking a year ago.

20 ACTING SECRETARY BEAM: The Legislative Vaccine

21 Task Force was created 3 weeks ago.

22 REPRESENTATIVE WARNER: Okay.

23 ACTING SECRETARY BEAM: We had an internal---

24 REPRESENTATIVE WARNER: Okay. I need to move —

25 Secretary, thank you. I need to move on. 130

1 So let's just skip that question. Do other

2 States have statewide vaccine registries?

3 ACTING SECRETARY BEAM: States have different

4 technology capabilities. It truly--

5 REPRESENTATIVE WARNER: That's not the question.

6 The question is, do other States have vaccine registries,

7 yes or no?

8 ACTING SECRETARY BEAM: Yes.

9 REPRESENTATIVE WARNER: Okay. Does Pennsylvania

10 have a statewide registry?

11 ACTING SECRETARY BEAM: Some have called our

12 Your Turn tool a statewide vaccine registry.

13 REPRESENTATIVE WARNER: Is it technically a

14 registry? Could I go there and put somebody down there

15 that would be notified that they could go get a vaccine at

16 a location?

17 ACTING SECRETARY BEAM: They would be notified

18 when they could go get a vaccine, yes.

19 REPRESENTATIVE WARNER: Okay. Why was Fayette

20 County advised not, advised by your Department not to

21 create a registry? That's the county I'm from. We were

22 advised -- our county went out of our way to create a

23 registry. Why were we advised not to create one?

24 ACTING SECRETARY BEAM: I'm not aware of the

25 advisement to Fayette County--- 131

1 REPRESENTATIVE WARNER: Okay; okay.

2 ACTING SECRETARY BEAM: ---to not create a

3 centralized registry.

4 REPRESENTATIVE WARNER: So I'm just a little

5 confused, because you're telling me that we do have a

6 registry. This is a statement from the Pittsburgh

7 Post-Gazette. It says, "Acting Secretary of Health

8 Alison Beam has said that a centralized registration site

9 was not technically possible, even though such systems are

10 used in Fayette County, the state of West Virginia, and

11 elsewhere. Ms. Beam said the main issue was inadequate

12 vaccine supply, not confusion over how to sign up."

13 Ms. Beam, I am out of time, but I would like to

14 personally invite you to come to Fayette County and come to

15 my district office for 1 hour, to just spend 1 hour

16 answering the phones. I promise you that you will see that

17 the logistics of signing up is just a big of a problem as

18 supply. It was logistics that caused the second-dose-first

19 debacle.

20 I just had a hospital in Uniontown that was

21 notified that their second dose would be taken away, and it

22 is extraordinarily confusing for especially elderly people

23 who are at most risk to have to play a bingo game on

24 whether or not the place that they registered to go get a

25 vaccine still has that vaccine, and then they could be 132

1 registered and have that vaccine pulled from them if they

2 don't show up, so someone doesn't get one.

3 The point being is that this State must have a

4 statewide registry. There is legislation out there created

5 that is bipartisan. So my final question is, will you

6 support this legislation and tell the Governor to support

7 it?

8 ACTING SECRETARY BEAM: So as we said this

9 morning, we are not shying away from conversations around a

10 centralized registry. We need the actual success

11 demonstrated to us and that it can be stood up in time to

12 serve the needs of Pennsylvanians to respond to this

13 crisis.

14 REPRESENTATIVE WARNER: Madam Secretary, my time

15 has expired. I want to thank you very much for your

16 answers and for joining us here today.

17 Thank you.

18 MAJORITY VICE CHAIR TOPPER: The Chair thanks the

19 gentleman and virtually will recognize the lady from

20 Delaware, Ms. Krueger.

21 REPRESENTATIVE KRUEGER: Thank you so much,

22 Mr. Chairman.

23 Thank you, Secretary, for coming before us today.

24 I know there has been many hours of questions, and I'm

25 grateful for the answers that you are providing. 133

1 First of all, I want to thank you and the

2 Governor for including 8.4 million for the State' s

3 10 county and municipal local health departments in this

4 year's budget. One-point-eight million of that is

5 allocated for Delaware County to create our first ever

6 county health department. We have been woefully behind

7 because we haven't had a health department here, and while

8 we're grateful to Chester County for working with us

9 temporarily, this funding will allow us to have our county

10 health department fully operational by January. So I'm

11 going to ask you, please, to do everything you can to make

12 sure that this important money stays in the budget.

13 In the meantime, though, Delaware County has been

14 behind. And it was just a few weeks ago that I was on a

15 call with one of your staff who acknowledged that vaccine

16 allocations to Delaware County and Chester County were

17 "lower than the necessary allocation" -- those were her

18 words -- and that the Department of Health was in the

19 process of rightsizing the number of doses to Delaware

20 County over the next few weeks.

21 So please, Madam Secretary, explain to me, when

22 will we see an increase in Delaware County? What kind of

23 corrective action is coming for us here?

24 ACTING SECRETARY BEAM: Thank you so much. I

25 appreciate it. And we are eager as well to have the 134

1 Delaware County Health Department. I think that will be a

2 great service for all of the folks that live in your

3 district.

4 With that being said, we do have a process by

5 which we have been evaluating where county allocations have

6 happened historically and making sure that we have a full

7 understanding of not just where there have been allocations

8 to the county municipal health departments but also the

9 hospitals and the other providers within them and

10 understanding, reflecting, that population and that

11 population over 65 and the COVID criteria to make sure that

12 we are aligned on that front.

13 Executive Deputy Klinepeter, I believe you have

14 detail on this one?

15 EXECUTIVE DEPUTY SECRETARY KLINEPETER: Yes.

16 I'm just trying to pull up the allocation for this week.

17 My computer, I apologize, is not cooperating as quickly as

18 I would have liked.

19 But I think overall, we have been working very

20 closely with others in Delaware County to ensure that the

21 appropriate amount of vaccine is being sent to Delaware

22 County. We're doing that in conjunction with our

23 second-dose smoothing strategy and as we are refining our

24 allocation science moving forward.

25 REPRESENTATIVE KRUEGER: So you don't have the 135

1 actual numbers for next week yet?

2 EXECUTIVE DEPUTY SECRETARY KLINEPETER: If you

3 can just give me one second, I will sort through the data.

4 REPRESENTATIVE KRUEGER: And you can send them

5 after the fact. It's just that we at our county, you know,

6 we sent a bipartisan letter, State Reps and Senators. Our

7 county government is frustrated as well. Our phones are

8 ringing off the hook. And according to the numbers that

9 the Chester County Health Department crunched, it appears

10 that as of February 11th, Delaware County was about 32,000

11 doses behind where we should be based on population

12 percentage.

13 So my request at this point, we have got to catch

14 up. Folks are desperate for this vaccine. We have 152,000

15 people eligible in phase A, 1A, on the county waiting list,

16 and they are desperate to get a vaccine and there is not

17 enough supply. I know there is not enough supply anywhere,

18 but we believe that we are 32,000 doses short of where we

19 should b e .

20 EXECUTIVE DEPUTY SECRETARY KLINEPETER: So I did

21 find the numbers. So the county of Delaware will be

22 receiving 1900 first doses of Moderna in total,

23 1,000 second doses of Moderna in total, one tray of Pfizer

24 for first doses for the week of February 22nd, which is this

25 week, and I'm happy to send you next week's numbers a 136

1 little later today.

2 REPRESENTATIVE KRUEGER: I would appreciate next

3 week's numbers as well.

4 And, you know, we are grateful, one of our

5 hospital systems stepped up to help us administer Pfizer

6 because our county didn't have the cold-storage

7 requirement. So we will take as many doses of Pfizer as

8 you can give us. We are ready to go. We have got multiple

9 vaccine sites that are ready to be stood up by the county.

10 We just don't have the supply.

11 Last question, Madam Secretary. So in my

12 district, there are school districts that are looking to

13 bring children back from a hybrid model to more than full

14 time. They could only do this by reducing the spacing

15 requirements from 6 feet to 3 feet. Now, I went on the CDC

16 website today. They still are recommending a 6-feet social

17 distancing. Has the Department of Health changed your

18 spacing recommendations for social distancing?

19 ACTING SECRETARY BEAM: No, we have not. At this

20 stage, we are still with the same guidance that was

21 previously administered, which had the 6 feet to the

22 maximum extent feasible.

23 REPRESENTATIVE KRUEGER: So what would you say to

24 school districts that are considering going to 3 feet? Is

25 that safe for our kids and our teachers right now? 137

1 ACTING SECRETARY BEAM: So "to the maximum extent

2 feasible" understands and appreciates that classroom

3 dynamics are difficult at times with that 6 feet, and I

4 think that's where the CDC was even able to expound upon

5 some strategies for schools to use where that 6 feet is

6 difficult.

7 We're working very closely right now with our

8 Department of Education to understand whether or not there

9 should be an adoption, again, of the CDC's more recently

10 promulgated guidance at the State level as well.

11 REPRESENTATIVE KRUEGER: Thank you.

12 And I joined a number of colleagues this week in

13 signing on to a letter requesting you to reconsider

14 guidance to move teachers into phase 1A. If we have got

15 local districts that are deciding that they are going to be

16 open with less than 6 feet of distance, you know, we need

17 to make sure that our teachers and our school staff are

18 safe. So I would ask you to consider the letter that we

19 sent this week.

20 Thank you, Mr. Chairman.

21 ACTING SECRETARY BEAM: Thank you for the letter.

22 We appreciate it.

23 MAJORITY VICE CHAIR TOPPER: The Chair thanks

24 the lady and recognizes the gentleman from Juniata,

25 Mr. Hershey. 138

1 REPRESENTATIVE HERSHEY: Thank you, Acting

2 Chairman.

3 Thank you, Secretary, for being here.

4 ACTING SECRETARY BEAM: Thank you.

5 REPRESENTATIVE HERSHEY: I have a question

6 related to the nursing home decisions again.

7 I have a grandmother in an assisted living

8 facility in Lancaster County, and protecting our senior

9 citizens matters a lot to me. So regardless of whether you

10 think it was a mistake to readmit COVID-positive patients

11 to our nursing homes, which you have to admit you didn't

12 answer that question earlier, you did admit that that was a

13 vulnerability just a few minutes ago. You said that that

14 was one of the ongoing vulnerabilities that Pennsylvania

15 faces, is how to protect these people in nursing homes. So

16 I'm curious about the data surrounding not only those

17 decisions but the data that the Department has found

18 related to the impact of those decisions.

19 In August, the United States Department of

20 Justice sent a letter -- that I'm certain you received,

21 because it was sent to the Governor's Office -- to the

22 States of New York, New Jersey, Pennsylvania, and Michigan

23 surrounding their nursing home policies. They asked the

24 number of public nursing home residents who contracted

25 COVID-19, the number of nursing home residents who died 139

1 from COVID-19, all State-issued guidance related to

2 admitting people to nursing homes, and also the number of

3 people who were admitted to nursing homes with positive

4 COVID diagnoses.

5 Now, Governor Cuomo was asked about this in a

6 press conference, and he infamously said that this was a

7 politically motivated question. But I'm just curious, when

8 you were with the Governor's Office, did you make any

9 effort to communicate this request from the Feds to the

10 Department of Health?

11 ACTING SECRETARY BEAM: So, I was made aware of

12 it, though I should really articulate, our Office of

13 General Counsel was the ultimate responder to that letter

14 for the Department of Justice.

15 REPRESENTATIVE HERSHEY: Okay. And did we

16 respond to the Federal Government?

17 ACTING SECRETARY BEAM: We did. Our Office of

18 General Counsel responded to the Federal Government.

19 REPRESENTATIVE HERSHEY: And ultimately, how did

20 we report those nursing home deaths in Pennsylvania? If a

21 person was in a nursing home and they were admitted to a

22 hospital and they passed away, was that counted if they

23 were put back in the nursing home? How exactly were those

24 tabulated?

25 ACTING SECRETARY BEAM: So I will be succinct, 140

1 but if you will allow me, there are different systems that

2 our current team has to operate off of, not only our case

3 positives but also our death reporting systems. What

4 Pennsylvania did is invested in not only putting our

5 skilled nursing facility addresses into the system so that

6 we could understand where an individual was a case positive

7 in a nursing home, but we also worked to allow the death

8 data to communicate with that so that we could actually

9 understand that even if a death had happened in a hospital,

10 if that was a skilled nursing facility or some sort of

11 nursing facility resident, that we truly understood that

12 that was ultimately a nursing home resident and a death

13 associated with a nursing home resident.

14 REPRESENTATIVE HERSHEY: I'm curious about the

15 delay in reporting some of this data. Spotlight

16 Pennsylvania had a September article decrying the lack of

17 transparency in the process. They talked about a nursing

18 home in Allentown that didn't have data for 7 weeks

19 reported, only to find out in August that it was one of the

20 hardest hit nursing homes in Pennsylvania. And Secretary

21 Levine was actually just questioned about this a few hours

22 ago in U.S. Senate hearings.

23 So what accounts for this lack of data or delay?

24 Is it a lack of resources or is it a lack of nursing home

25 compliance? What is happening here? 141

1 ACTING SECRETARY BEAM: Sure. I'm actually going

2 to turn it over to Executive Deputy Secretary Klinepeter,

3 who is familiar with this issue.

4 EXECUTIVE DEPUTY SECRETARY KLINEPETER: Thank

5 you, Acting Secretary.

6 So the data that is on our website is actually

7 self-reported data from the facilities. The Secretary of

8 Health, Dr. Rachel Levine, issued an order back in May of

9 2020, I believe, requiring facilities to report this data

10 so that we could publicly report it regarding cases and

11 deaths. There are sometimes lags in the data reporting,

12 which can be due to everything from, you know, quite

13 frankly, staff being laser-focused on caring for their

14 residents, their staff turnover, and the like.

15 So we have worked hand-in-hand with our skilled

16 nursing facilities to improve that data reporting. At

17 best, we get around 80 to 85 percent compliance with that

18 reporting. There was a lag over the holidays back in

19 December where we did see lower rates of reporting, but we

20 doubled down our efforts to work with the facilities and to

21 improve that data reporting.

22 The data that Acting Secretary Beam was referring

23 to previously is from some of our internal systems. Those

24 are not self-reported data. Rather, those come through

25 more unified systems that our health-care systems use. 142

1 REPRESENTATIVE HERSHEY: Thank you.

2 You mentioned -- and I'm out of time so I have to

3 wrap up here. But you mentioned that these facilities are

4 required to report that data, but so far, we only have an

5 80- to 85-percent compliance rate. Well, with the amount

6 of nursing homes we have in Pennsylvania, that's still

7 dozens that you are not hearing from.

8 So I would just encourage you guys in the future

9 to continue trying to get this data to the best of our

10 abilities so that we know the impact that this horrible

11 virus has had on our senior living facilities.

12 Thank you for your time.

13 MAJORITY VICE CHAIR TOPPER: Secretary Beam, you

14 had mentioned that the Administration has responded to the

15 Department of Justice inquiry. Is that correct?

16 ACTING SECRETARY BEAM: That is correct.

17 MAJORITY VICE CHAIR TOPPER: Could you provide

18 that response to this Committee?

19 ACTING SECRETARY BEAM: Yeah. I will have our

20 staff follow up or our Office of General Counsel follow up.

21 MAJORITY VICE CHAIR TOPPER: Thank you.

22 ACTING SECRETARY BEAM: Of course.

23 MAJORITY VICE CHAIR TOPPER: Next, the Chair

24 recognizes the gentleman from Allegheny County, virtually,

25 I believe, Mr. Gainey. 143

1 REPRESENTATIVE GAINEY: Thank you. Thank you,

2 Mr. Chairman.

3 Madam Secretary, thank you for being here today.

4 My question is, after the State Auditor released

5 a report on Pennsylvania's nursing home industry in 2016

6 documenting failures of oversight on the part of the

7 Department of Health, the Department committed to

8 strengthening Pennsylvania's nursing home regulations,

9 which have not been updated in decades. Nearly 5 years

10 later, the DOH has still not released the nursing home, the

11 new nursing home regulation, despite repeated calls from

12 elder advocates for stronger oversight. Why has the

13 regulatory process taken so long, and when does the

14 Department plan to release these regulations to protect our

15 seniors?

16 ACTING SECRETARY BEAM: So I will be concise.

17 With entering in and knowing the Governor's

18 duration of this Administration, we have a bold regulatory

19 agenda -- the long-term care facility, the hospital,

20 infectious disease, medical marijuana. But what we want to

21 make sure of with the long-term care facilities, we know

22 and appreciate that there was consensus building in the

23 beginning. We had stakeholder groups that came together to

24 make sure that we were really crafting these regulations in

25 the reflection of the needs of our long-term care 144

1 facilities in Pennsylvania, because as you noted, they are

2 incredibly outdated at this point.

3 But we also know that we have to take the lessons

4 learned in this last year from this pandemic and also make

5 sure that the long-term care facility regulations reflect

6 that. And so we're working real-time right now, kind of

7 dual tracking it, and we're responding to the pandemic,

8 making sure that we are supporting our long-term care

9 facilities but we're also drafting those regulations to

10 have those facilities be in the best position possible so

11 that when inevitably we unfortunately have our next

12 pandemic, they are in a better position to be able to be

13 responding to this crisis.

14 REPRESENTATIVE GAINEY: Will there be any

15 updates, like, as you go on, just to keep people informed

16 that the process is still moving forward and that everybody

17 is still working in a way that is going to deliver the new

18 regulations? Is there a way to have a benchmark on what -­

19 not a benchmark, just a report, just to let people know

20 what's going on so they don't just think that there's a

21 stalemate?

22 ACTING SECRETARY BEAM: Sure.

23 So we publish our regulatory agenda in the

24 Bulletin, but also we have provided updates on when we have

25 had critical pieces of the long-term care regulatory 145

1 package that we have been able to share with stakeholders.

2 We can ramp up that frequency.

3 I think it has been demonstrated in the last

4 4 weeks, we do have a tremendous dedication to being

5 communicative, if not overly communicative, with not just

6 the Legislature but stakeholders broadly. And so if that's

7 something that could be helpful for you, we'll work with

8 our Policy Office to make sure that we can provide updates

9 as we try and progress quite quickly through a rather

10 ambitious regulatory agenda.

11 REPRESENTATIVE GAINEY: Okay. Thank you.

12 MAJORITY VICE CHAIR TOPPER: The Chair thanks the

13 gentleman and recognizes the gentleman from Northampton,

14 Mr. Mako.

15 REPRESENTATIVE MAKO: Thank you, Mr. Chairman,

16 and thank you, Madam Secretary, for being here today.

17 My first question is, many families across my

18 district and throughout Pennsylvania have been unable to

19 visit their loved ones residing in long-term care

20 facilities for nearly a year now, and as the long-term care

21 residents and their staff receive vaccines, you know, when

22 can we expect the Department to issue guidance to these

23 providers to allow their families to come in and see their

24 loved ones?

25 ACTING SECRETARY BEAM: Thank you so much, and 146

1 this is an important topic.

2 As we have thought through and as we have

3 discussed today the trauma of the last year, we understand

4 that isolation is a trauma unto its own right as well. And

5 so we have worked not only to be complying with the Federal

6 guidance, but also realizing that our ability to see our

7 loved ones that are in nursing facilities is also making

8 sure that we are doing it safely and realizing that a lot

9 of our nursing facilities actually had the spread of COVID

10 attributed to what was reflected in their community

11 broadly. So our overarching "being able to move the

12 needle" on where we stand by way of COVID cases and deaths,

13 decreasing is really helpful here.

14 But specific to your question about what is

15 forthcoming by way of guidance from us, I'm actually going

16 to turn it over to the Executive Deputy Secretary, who has

17 more familiarity with this area.

18 EXECUTIVE DEPUTY SECRETARY KLINEPETER: Thank

19 you, Acting Secretary.

20 So presently, visitation is allowed in skilled

21 nursing facilities if they meet certain characteristics,

22 such as residing in a community that has a low or moderate

23 spread of community transmission, if they have been COVID

24 free for 14 days and are not experiencing an active

25 outbreak, if visitors are willing to adhere to good public 147

1 health practices such as social distancing, mask wearing,

2 et cetera, and so that is actually a Federal guidance at

3 this time that the State is responsible for enforcing. In

4 fact, CMS goes so far as to say visitation is mandatory at

5 this time.

6 REPRESENTATIVE MAKO: And that's good to hear.

7 And the reason why I ask is because I know Rhode Island,

8 Kentucky, they have Democratic Governors and they are

9 opening back up, Ohio, and even New York. And as we heard

10 earlier, New York's Governor might be in a little bit of

11 hot water, but we're not going to go into that.

12 I did have one final question, because we're on

13 month 11 of flattening the curve here. What point, what

14 matrix, or what level of herd immunity will you start to

15 advocate to the Governor that we can go back to normal?

16 ACTING SECRETARY BEAM: So that is an active

17 real-time discussion with the Governor right now, and we

18 share your eagerness, right? We want to have a way to have

19 folks, you know, like, we are going to be on the other side

20 of this pandemic.

21 We know that the vaccine is part of it, but is

22 not completely. We need to make sure that we still are

23 wearing our masks and so we can, again, prevent what we

24 were always trying to prevent, not only saving lives but

25 preventing our hospitals from becoming overrun. 148

1 We have had progress made, not only recently with

2 the case declines, the death rate decline, but then also

3 our hospitalizations are also on the decline. And so

4 Pennsylvania is progressing in the right direction, which

5 is a real-time discussion with the Governor on how we are

6 going to move forward with relaxation and mitigation

7 efforts.

8 REPRESENTATIVE MAKO: And that sounds good.

9 And actually, I got another question. What are

10 yourself and the Department doing to advocate for vaccines

11 to have people go out? Because as we heard earlier, some

12 people might not be willing to get the vaccine. What are

13 you doing to advocate for vaccines?

14 ACTING SECRETARY BEAM: So, Representative, this

15 is our issue right now.

16 We know that right now in this moment of the

17 vaccine rollout that we do not have enough supply, but we

18 are going to get to a point whereby we are going to have

19 supply, likely with advocacy that we work with. The

20 Federal Government has been hearing from us repeatedly that

21 we need more, but we're going to get to a point where we

22 have more and folks won't be as interested in getting it,

23 and that's where we need to really be able to be strategic

24 in allowing folks to feel that the safety and the efficacy

25 of the vaccine is trusted. And that's why the competency 149

1 of this process is so important, and what we're working to

2 instill in folks is making sure that they trust that the

3 vaccine is right for them and their community. It's how

4 they're going to protect their family.

5 Specifically, we have an outreach and education

6 campaign that we have designed. Part of it is actually

7 with the spend of some of the vaccine dollars that I had

8 referenced earlier, but we're going to have to make sure

9 those vaccine dollars are actually in our bank account

10 before we start spending them to make sure that we can get

11 that outreach and education campaign off the ground at the

12 right time so that we are also trying to preempt that

13 vaccine hesitancy.

14 REPRESENTATIVE MAKO: All right. Well, I am out

15 of time. I appreciate your answers, and thank you for your

16 time, ma'am.

17 ACTING SECRETARY BEAM: Thank you.

18 MAJORITY VICE CHAIR TOPPER: The Chair thanks

19 the gentleman and recognizes the gentleman from Lancaster,

20 Mr. Zimmerman.

21 REPRESENTATIVE ZIMMERMAN: Thank you,

22 Mr. Chairman, and thank you, Madam Secretary, for being

23 with us today.

24 So I noticed on PennLive where the Administration

25 actually hired an international management firm to help 150

1 with the vaccine rollout, a group called Boston Consulting

2 Group. It looks like the contract runs from now through

3 August at a cost of about $11.5 million. Could you explain

4 exactly what this group is going to be doing and who

5 actually made the decision to hire this firm?

6 ACTING SECRETARY BEAM: Absolutely.

7 So we brought on the consulting team, because as

8 we had referenced earlier, we want to make sure to have the

9 right logistics behind our strategy. So this team is

10 working primarily, first, on getting our data straight. We

11 need to have good data system interoperability, especially

12 with that Federal system. I haven't really alluded to it

13 today yet, but there is a system that the Federal

14 Government is using to communicate with States on the

15 vaccine. And so by having a firm that is familiar with how

16 other States are interoperating with it is helpful for us

17 here in Pennsylvania.

18 But then on top of the data, we are really

19 working on making sure that that allocation formula can be

20 as transparent and as predictable as possible so that our

21 providers, who you have heard through others of your

22 colleagues today, can have more predictability and plan to

23 the extent that Operation Warp Speed gives us

24 predictability and planning.

25 But also, they are working on that provider 151

1 network honing, which we have talked about as well, making

2 sure that we know right now that our provider network, not

3 only are those that are really having (audio malfunction)

4 but that we're reaching those equitable corners of

5 Pennsylvania.

6 Our Commonwealth has a lot of diverse

7 geographies, and if we're going to get ahead of vaccine

8 hesitancy, we have to be thinking through what are the best

9 provider partners to overcome that vaccine hesitancy. And

10 so they are working with us on making sure that we have the

11 highest group but that we're balancing it with equity,

12 bringing in PEMA and any of the mass vaccination sites and

13 community vaccination sites that they have designed and are

14 also going to be able to supplant our provider network

15 with.

16 REPRESENTATIVE ZIMMERMAN: Sure, but who actually

17 made that decision? Was it the Department of Health or the

18 Governor or---

19 ACTING SECRETARY BEAM: The Department of Health

20 made a recommendation to the Governor that we partner with

21 them, to move forward using them and their expertise to

22 improve our vaccination rollout.

23 REPRESENTATIVE ZIMMERMAN: So was there no

24 Pennsylvania companies capable of this, doing this kind of

25 work? 152

1 ACTING SECRETARY BEAM: So this consulting firm

2 is somewhat uniquely situated in that it has a lot of other

3 States currently as clients and that we're able to actually

4 benefit from the lessons learned of other States and be

5 able to really transpose I think what some of your

6 colleagues have asked of us, which is bring in best

7 practices to allow there to be a strategy that is really

8 reflective of a nationwide success strategy.

9 REPRESENTATIVE ZIMMERMAN: Okay. So was it

10 actually put out for bid, for a bid, like we are required

11 to do throughout our State in public contracts, or was it

12 not?

13 ACTING SECRETARY BEAM: So the need--

14 REPRESENTATIVE ZIMMERMAN: And if not, why not?

15 ACTING SECRETARY BEAM: Sure.

16 So the need for this intervention was so urgent,

17 and I can't say enough how urgently we needed resources on

18 board. So with transitioning into this leadership

19 position, we recognized immediately, we oriented ourselves

20 in the crisis. We realized that there needed to be these

21 resources that could really bolster what the existing team

22 was doing, but put controls in place and allow us to have

23 improvements on our vaccine allocation strategy more

24 broadly. The urgency of it required an emergency

25 procurement. 153

1 REPRESENTATIVE ZIMMERMAN: Yeah. It still seems

2 to me it should have been bid, because that's really

3 required, you know, throughout the State on anything,

4 anything public. But it also is interesting to me that,

5 you know, a State like Connecticut and also Rhode Island

6 and others contracted with this same firm, but they were

7 spending a million, a million and a half, or 2 million

8 versus 11.5. So it seems a little excessive.

9 Also, a little different question, but also

10 related. It' s my understanding that the Department is not

11 keeping any records of correspondences with consultants or

12 advisors. Is that true, and if so, why?

13 ACTING SECRETARY BEAM: That's unfamiliar to me.

14 REPRESENTATIVE ZIMMERMAN: Okay. Is that

15 something, information you could get for us whether that

16 happens or not?

17 ACTING SECRETARY BEAM: Sure. We can seek -- I

18 would like to consult with counsel on that, but we can see

19 what we can provide you by way of communications.

20 REPRESENTATIVE ZIMMERMAN: Okay. Thank you.

21 Thank you, Mr. Chairman.

22 MAJORITY VICE CHAIR TOPPER: The Chair thanks the

23 gentleman.

24 And Secretary, we can consult with our counsel as

25 well to see if we can get on the same page. 154

1 We're now going to move on to a second round of

2 questions. Before you panic too much, there's not a ton of

3 Members on that list. We are going to our second round of

4 questions, and we'll start with the lady from Allegheny

5 County, Ms. Kinkead.

6 REPRESENTATIVE KINKEAD: Thank you, Mr. Chairman.

7 Thank you, Madam Secretary.

8 I wanted to follow up on my questioning about

9 disability access with the vaccines.

10 I found your answer to be a little bit lacking,

11 and so I wanted to kind of suss it out a little bit. I

12 appreciate that there is this 877 number, but as I think

13 we are all aware, disability is not one-size-fits-all,

14 and the accommodations that are necessary to allow people

15 to have access to vaccinations also should not be

16 one-size-fits-all.

17 People with communication issues often cannot

18 utilize the phone line because the phone doesn't recognize

19 the voice of their communication device or they can't

20 respond to the prompts quickly enough for the system to

21 register it. People with mobility issues are facing

22 difficulties following the dial prompts in time to get

23 through, and, you know, it's a dexterity issue.

24 So I'm wondering if you can, and maybe you need

25 to provide me with sort of an outside follow-up, let me 155

1 know what it is that the Department is doing to ensure that

2 there is full accessibility for those with disabilities to

3 be able to access these very critical vaccines.

4 ACTING SECRETARY BEAM: Yeah. We would be happy

5 to not only provide you follow-up but partner with you on

6 thinking through solutions. We do not shy away from trying

7 to allow others expertise in certain areas to really inform

8 our strategy, and so to the extent that we would want to

9 bring you and your ideas into the fold, too, we're happy to

10 do so.

11 I think already the modifications and

12 improvements that we have made to our vaccine guide are

13 indicative of how dedicated we are to continuously

14 improving what we have been able to provide for folks. And

15 so I'm happy to engage with you, happy to provide you what

16 we have to date, and provide whatever your constituents

17 would deem necessary.

18 REPRESENTATIVE KINKEAD: Okay. Yeah. I think

19 that rather than spending my full 5 minutes kind of sussing

20 out everything, I think that would be the better plan, is

21 to kind of do this offline. So I appreciate your

22 willingness to work with me on that.

23 ACTING SECRETARY BEAM: Of course.

24 MAJORITY CHAIRMAN SAYLOR: Our next questioner is

25 Representative Clint Owlett. 156

1 REPRESENTATIVE OWLETT: Thank you, Mr. Chairman.

2 And Secretary, I want to thank you for sticking

3 with us here today. I know it has been a long day, and I

4 realize that a lot of these questions you probably may not

5 have been super involved with the decisions. I mean, you

6 have been involved with the Governor's Office from the

7 beginning of this, but your leadership has been different

8 at the Department of Health, and I appreciate that.

9 I did want to have a question here for you. It

10 has to do with your testimony. In your testimony you

11 state, "While the manner in which the Governor presented

12 his budget proposal before the General Assembly was

13 different this year, the Governor laid out a strong agenda

14 that will help advance our vision of a healthy Pennsylvania

15 for all. That vision includes accelerating and improving

16 our vaccine rollout... "

17 Did the Governor talk about the vaccine rollout

18 in his Budget Address to the General Assembly?

19 ACTING SECRETARY BEAM: So I' m trying to remember

20 if there was a specific mention of it. I know that there

21 was an acknowledgment of COVID, but I will have to go back

22 and check his specific budget address to understand if the

23 vaccine was explicitly mentioned.

24 REPRESENTATIVE OWLETT: So I can answer that

25 question for you: No. We searched the transcript. I even 157

1 had somebody watch it twice this afternoon. It was not

2 mentioned. Vaccine was not mentioned once in the

3 Governor's proposal. Would you agree that this is a

4 disconnect from what's really going on on the ground?

5 I mean, he talked about raising taxes. He talked

6 about recreational weed, all kinds of different things, but

7 he did not at all talk about the vaccine. Was that a

8 mistake?

9 ACTING SECRETARY BEAM: The Governor is

10 thoroughly involved in our vaccine process. I think the

11 Legislative Task Force members can really be a testament to

12 that. The Governor is extremely interested in the success

13 of this program, and I don't think he minces words when he

14 explains that Pennsylvania needs to be doing better.

15 And so I think he has been very clear on his

16 expectations of what he wants by way of a successful

17 vaccine rollout, and I think he has only further

18 demonstrated his level of dedication to this by his

19 involvement in the Legislative Task Force.

20 REPRESENTATIVE OWLETT: I appreciate that, and he

21 has been engaged on a different level. I just wish it

22 would have been in the budget production that we saw here

23 in the General Assembly.

24 I mean, if it is such a big priority, and you

25 wrote about it in your testimony, but it was not there, and 158

1 I think the people of the Commonwealth were waiting for it.

2 We were waiting for it. I was waiting for it. I know it's

3 in the budget from the Federal money that is coming, but it

4 wasn't in that presentation, and that's discouraging. It's

5 hard to say that it's a priority when it wasn't in that

6 presentation. I mean, this is the budget.

7 But another question. In the spirit of

8 transparency, one of my colleagues from Juniata County

9 talked a little bit about nursing home deaths, and New York

10 State has done a deep dive and investigation. Their

11 Attorney General did a deep dive into that, and what they

12 found was unbelievable. Would you comply with any future

13 investigations in Pennsylvania trying to get to more

14 accurate information on nursing home deaths here?

15 ACTING SECRETARY BEAM: So we have actually

16 consulted with our Governor's Office on this to make sure

17 that to the extent we can work with an investigation, we

18 will do so, but that would obviously be in close

19 consultation with counsel.

20 REPRESENTATIVE OWLETT: Okay. So you will work

21 with whoever does that investigation. Hopefully, somebody

22 does.

23 Lastly, I think lastly, back in our last Health

24 hearing -- I serve on the Health Committee as well. It was

25 back, I don't know, early on in February or late January. 159

1 I can't remember. We talked a little bit about the metrics

2 that you use determining how much vaccine to send to each

3 county -- population, active case count, and death rate.

4 I didn't ask this question during that hearing because I

5 wanted to reach out to the Department of Health. One of

6 the counties that I serve really feels like, and I think

7 they are right in realizing that their numbers have been

8 very low compared to surrounding States with similar

9 numbers. I believe you are aware of these conversations.

10 However, I reached out to the Department of Health 23 days

11 ago after that hearing asking for how these numbers were

12 calculated for this specific county. Is 23 days normal for

13 an inquiry from a Legislator?

14 ACTING SECRETARY BEAM: We work very quickly to

15 try and get responses, just as demonstrated for our lunch

16 break today to try and get responses to this morning's

17 question.

18 And so for your response particularly, I'll work

19 with the team to get you a swift response.

20 REPRESENTATIVE OWLETT: I sure hope so.

21 Twenty-three days is a long time, and we need those

22 answers. We would appreciate those answers as quickly as

23 possible.

24 That's all I have, and thank you again for being

25 here and sticking with us today. 160

1 Thank you, Mr. Chairman.

2 MAJORITY CHAIRMAN SAYLOR: Our next questioner is

3 Representative Lawrence.

4 REPRESENTATIVE LAWRENCE: Thank you,

5 Mr. Chairman.

6 Madam Secretary, I am looking here at a form from

7 the Pennsylvania Department of Health's website, the

8 Pennsylvania Department of Health COVID-19 wasted and

9 destroyed vaccine form, and it looks like it's a form where

10 providers can complete how many COVID-19 vaccines they have

11 wasted or destroyed. Can you tell me, what has the

12 reporting been on this? To date, how many COVID vaccines

13 have been wasted or destroyed in Pennsylvania?

14 ACTING SECRETARY BEAM: Yeah. So we have a very

15 low rate of wasted vaccine in Pennsylvania, which I think

16 is indicative of how precious of a commodity folks are

17 handling. But for the specific numbers, I'll actually hand

18 it over to Executive Deputy Secretary Klinepeter for the

19 specifics.

20 EXECUTIVE DEPUTY SECRETARY KLINEPETER: Thank

21 you, Acting Secretary.

22 So presently, we have 1,529 doses reported as

23 wasted. This is raw data, so I will caution that we have

24 to still validate the data. And based on our team's

25 expertise, we believe that the number is likely closer to 161

1 the 1200 range. So anywhere between that 1200 and 1529 is

2 what has been reported as wasted to date.

3 REPRESENTATIVE LAWRENCE: Very good. I

4 appreciate that. I was curious about that.

5 I also wanted to echo the comments of my

6 colleague who just spoke previously here, Representative

7 Owlett.

8 I had sent a letter over to the Department of

9 Health on January 19th with regard to COVID vaccinations,

10 and I actually sent it as well to Secretary Redding and to

11 the Department of Education, and I have not received a

12 response from anyone on it. And specifically the issues we

13 were addressing, that I was addressing in this letter was

14 the prioritization of vaccinating teachers. And I look at,

15 you know, the State of Delaware, which adjoins my

16 legislative district, very close to my legislative

17 district. They are vaccinating teachers. I know for a

18 fact they are. And I have not heard anything back on this

19 issue. I would certainly appreciate a response on this

20 issue.

21 ACTING SECRETARY BEAM: Yes, Representative.

22 We're happy to do that.

23 I think also I just want to reiterate, we share

24 the need to have those that are truly our frontline

25 workers, which are that 1B category, vaccinated as quickly 162

1 as possible. Obviously, that's on balance with making sure

2 that we don't expand 1A further and knowing that our

3 seniors in some of our long-term care facilities are still

4 working through their actual vaccinations.

5 So hopefully with the increased supply from the

6 Federal Government or new and improved vaccines, we'll be

7 able to smoothly transition into having those populations

8 vaccinated.

9 REPRESENTATIVE LAWRENCE: So I appreciate that

10 answer, and I don't want to go on and on about it. I guess

11 at the end of the day, it's just a matter of prioritization

12 and making choices, right? So the Wolf Administration has

13 made decisions here, and for whatever reason, we have

14 created this 1A category where a third of the population,

15 or more, actually, in Pennsylvania, falls into one

16 category. And we can go back and forth and debate whether

17 that was a good idea or not. At this point, the decision

18 has been made.

19 But I do think it is interesting as we look at

20 what the decisions that other States have made where they

21 have been able to deliver these vaccines faster. They do

22 not have 1 million vaccines stuck in the system. They

23 have been able to move them forward more quickly. They

24 have been able to somehow find space to vaccinate

25 educators. 163

1 I know that, you know, this is not a position

2 that is solely held by myself. I know folks on both sides

3 of the aisle, the PSEA, every educational organization in

4 the State I know has petitioned the Governor on this issue.

5 So I'll leave it there. I do appreciate you

6 being before the Committee today.

7 Thank you, Mr. Chairman, for the opportunity to

8 ask a second question. Thank you.

9 MAJORITY CHAIRMAN SAYLOR: Thank you.

10 Representative Jesse Topper.

11 MAJORITY VICE CHAIR TOPPER: Thank you, and good

12 afternoon again, Secretary Beam.

13 Earlier in response to a question, you mentioned

14 something that I just felt the need to follow up on, and

15 that was about the city of Philadelphia.

16 You had mentioned that they were on their own

17 plan. Could you kind of explain where Philly is in terms

18 of the rest of the State? Are they under any oversight in

19 terms of their vaccination rollout from the Department of

20 Health?

21 ACTING SECRETARY BEAM: So the Federal Government

22 chose I believe five to six big cities that they were going

23 to have a separate allocation. And so as part of Operation

24 Warp Speed's strategy, Philadelphia was selected as one of

25 those cities that receives its own allocation, and in that, 164

1 Philadelphia actually promulgates its own guidance of how

2 those phases are going to progress through the county. And

3 so Philadelphia really has a lot of autonomy with how it is

4 structuring its vaccine rollout.

5 Again, I think the question was actually about

6 the context of coordination, and we really are trying to

7 stay coordinated, because we know that when one county is

8 different in some sort of way, it does generate confusion

9 at times.

10 MAJORITY VICE CHAIR TOPPER: Well, and I don't -­

11 correct me if I'm wrong, but I don't think I am. We have

12 residents from other counties that are actually going into

13 the city of Philadelphia, registering and going in to

14 receive vaccinations. Are you at the Department getting

15 any information? Is the city communicating with you in

16 terms of who is being vaccinated, even if you're not

17 overseeing the actual program?

18 ACTING SECRETARY BEAM: Yeah. So Philadelphia

19 does have its own PhilaVax system by which it is actually

20 keeping track of who it is vaccinating. We are working on

21 communicating those two systems, and then we add in. Those

22 get reported up to the CDC. And so making sure that all of

23 those systems are communicating in as real time as possible

24 is absolutely not only a current issue, but we are also

25 building better. Remember, the ELC grant had that IT 165

1 investment, and this is one of the pieces of it.

2 MAJORITY VICE CHAIR TOPPER: So we were hearing,

3 you know, and there's reports -- if there are reports of

4 issues that come out through the city, are you able to sort

5 of claw back any oversight, or is it because it's a Federal

6 program, because they are designated through Operation Warp

7 Speed, basically you are just able to collect data?

8 ACTING SECRETARY BEAM: So we are working closely

9 in coordination, but primarily there is Philadelphia

10 autonomy over how they are running their vaccine strategy.

11 MAJORITY VICE CHAIR TOPPER: And I guess, on the

12 flip side of that, would there be any advantages to seeing

13 what -- I'll be honest, there are a lot of -- now, none

14 that I represent. I don't have a countywide health

15 organization in Bedford, but a lot of the larger counties

16 do. Is there wisdom to giving some of these larger

17 counties more autonomy in how they can at least distribute

18 and execute their plans?

19 I mean, if they know the quantity of what they

20 are getting, it seems to me that they would possibly be

21 able, as the boots on the ground in the local area, to be

22 able to execute the strategy of distributing those vaccines

23 more effectively than it has been.

24 ACTING SECRETARY BEAM: So actually, this is a

25 path that we have talked about at length with our 166

1 Emergency Management Agency, because as you know, while the

2 emergency management coordinators that are actually

3 situated in each county, many of the counties had actually

4 crafted their plans for how they would be able to run a

5 strategy by way of a community vaccination clinic or a mass

6 vaccination clinic.

7 I can't reiterate enough that that is what we

8 want to get to by way of being able to invest in these

9 strategies, but we need vaccine to do it. And so we

10 started investing in making sure that there is the actual

11 allocation that we can have those community vaccination

12 clinics be successful, but we want to do it in a way that

13 actually is in straight partnership with the Pennsylvania

14 Emergency Management Agency and their county coordinators

15 as well.

16 MAJORITY VICE CHAIR TOPPER: I appreciate that.

17 And then just one final follow-up to Representative Warner

18 from earlier.

19 Just so that you're aware, not only was that a

20 suggestion for a task force from the General Assembly, it

21 was actually passed as a bill through the House and through

22 the Senate, and ultimately it was vetoed by the Governor

23 and the Administration. So it wasn't simply, you know, we

24 all wrote a letter. I mean, it was debated on the House

25 Floor. I think I spoke on that bill on the House Floor. 167

1 We passed it, and it was vetoed. So that will help your

2 situational awareness with that particular piece of

3 legislation.

4 Thank you, Mr. Chairman.

5 MAJORITY CHAIRMAN SAYLOR: With that, I recognize

6 Representative Bradford.

7 MINORITY CHAIRMAN BRADFORD: Thank you, Chairman.

8 And thank you, Secretary. I realize it has been

9 a long day and obviously it has been a long 11 months.

10 People obviously are very frustrated with 11 months of

11 everything the pandemic has brought, and understandably.

12 The vaccine offers hope in a way that people have long been

13 waiting for, and people are understandably anxious and

14 appreciate what you are trying to do to correct a system

15 that is by no means perfect.

16 I have two simple questions, I think just to kind

17 of hopefully set the stage for something productive from

18 today's meeting.

19 How are things going with the Federal Government?

20 What's the trajectory like? Are we hitting timelines in

21 terms of expectations?

22 One of the things that I myself have been

23 critical is just, you know, you have got to manage

24 expectations when people have been through what they have

25 been through for the last 11 months and people are so 168

1 looking for hope. You know, everyone wants to cling for

2 any hope, even if it's unrealistic in terms of timeline and

3 scope.

4 So obviously supply is the major issue.

5 Logistics flows from there. How are we doing in terms of

6 the Federal Government? What is going on? Is it getting

7 better? Is it getting worse? And what does that mean for

8 the Commonwealth?

9 ACTING SECRETARY BEAM: Sure. Thank you.

10 So the one improvement that we have been working

11 towards, which is our loudest and most vocal piece of

12 advocacy after more vaccine, is more visibility. We need

13 to know what's coming down the pike so that we can plan,

14 and any visibility we have we'll clearly pass on to the

15 provider partners that are doing the vaccinating.

16 And so we have been able to get rough

17 understandings of future weeks' allocations, and I actually

18 believe that the Governor's call that was recently held,

19 the Governor was understanding that we might even get more

20 future visibility, and that means predictability, which

21 means we can pass it on to other providers and plan better.

22 And so I think that that will be, if we know that the

23 supply has already been a request that we have said

24 ad nauseam, I think that the next with visibility has been

25 improved. 169

1 I would offer that we can always communicate

2 better, and so I think making sure that we have our

3 established channels with the right folks at the Federal

4 Government. And especially through the transition of the

5 Federal Administration, we're always trying to make sure

6 that we have that communication as frequent as possible.

7 And so as they are making any strategic decisions about

8 their strategy by way of investing in pharmacy partnerships

9 or FQHCs and the like, that we're able to do it and plan

10 with them.

11 Now, this Federal Government has also been

12 incredibly cooperative with the Association of State and

13 Territorial Health Officials, which allows all 50 States to

14 have routine communications with them, and we vocalize

15 these needs on those calls as well. And so I think they

16 have been receptive to our requests.

17 MINORITY CHAIRMAN BRADFORD: By predictability

18 and transparency in terms of seeing what's coming, are they

19 hitting the benchmarks that they are giving you? And just

20 by a matter of example, how many doses do you expect for

21 let's say next week or the week following, just to give me

22 an idea of what that ramp-up may look like.

23 ACTING SECRETARY BEAM: Sure. So actually what

24 we learned more recently on a Governor's call is that there

25 actually was a commitment that we would have at least, at 170

1 least similarly situated amounts of vaccine come to

2 Pennsylvania the next 2 weeks. And so that at least is a

3 little bit of stability that we know it won't decrease.

4 And so by way of actual allocation amounts, we

5 have the weekly numbers that I can give you. So we just

6 were able to receive our numbers last night, I believe it

7 was, yesterday, where we have, and I'm happy to read these

8 off to you if that would be helpful.

9 MINORITY CHAIRMAN BRADFORD: Please do, and just

10 give me like, do you get a week ahead? Like, how much of a

11 head time or lead time do you have to plan for?

12 ACTING SECRETARY BEAM: So I'll read these off

13 first.

14 So Moderna dose one, it's 112,400. Pfizer dose

15 one, it's 129,870.

16 Moderna dose two, it's 104,000, and Pfizer dose

17 two, it's 71,175.

18 So what we have by way of visibility is a

19 commitment that we will at least receive that similar

20 amount the next 2 weeks.

21 MINORITY CHAIRMAN BRADFORD: Okay. So they're

22 telling you you have 2 weeks and about 150,000 of each dose

23 for each supplier.

24 ACTING SECRETARY BEAM: A little bit more of the

25 Pfizer than the 150,000 it would add up to. 171

1 EXECUTIVE DEPUTY SECRETARY KLINEPETER: Yeah.

2 It's more like 200 for Pfizer.

3 MINORITY CHAIRMAN BRADFORD: So when you hear

4 that frustration obviously in Members' voices and in their

5 constituents' voices, at the end of the day, that number is

6 just not sufficient to deal with the pent-up demand and the

7 expectation that is out there.

8 ACTING SECRETARY BEAM: Yes. We fully appreciate

9 it, and we have not only had the Governor advocate, again,

10 we're using every channel we have to say, please, really

11 invest in whatever means necessary to get more vaccine.

12 MINORITY CHAIRMAN BRADFORD: Okay.

13 Let me just ask you this: Is there anything the

14 Legislature can or should be doing to help? I realize, you

15 know, everyone is frustrated, and again, I keep harping on

16 that. But what can the Legislature do to be a productive

17 partner and a cheerleader or support in terms of resources

18 and to not be, frankly, hindering the process but helping

19 the process?

20 ACTING SECRETARY BEAM: Look, I think there has

21 been a lot of communication in the last 4 weeks, and I hope

22 folks know that we have heard you. We have pivoted

23 strategically reflective of what you all have communicated

24 to us, and you are so critical to understanding what

25 constituents are experiencing in various ways. And so we 172

1 hope to enhance that communication both ways, that you can

2 come to us and that hopefully by our routine meetings with

3 the full General Assembly but then also caucuses and the

4 like, we're able to keep information flowing both ways in

5 questions and answers.

6 I truly can't thank enough the Legislative Task

7 Force members. They have had a tremendous lift over the

8 last 2 weeks in really trying to be able to wrestle some

9 complex strategies with us. And so really, that

10 participation is really tremendously helpful.

11 MINORITY CHAIRMAN BRADFORD: Great.

12 Well, thank you. I realize you have an

13 impossible job with expectations being through the roof,

14 and people's frustration just, you know, is obviously right

15 on the edge.

16 So I understand it's a difficult job. We all are

17 indebted for the work that your folks have been doing for

18 the last 11 months. We realize it's impossibly difficult.

19 But having said that, you know, obviously we have got to

20 double down for the next couple of months to get through

21 this, and we appreciate the work your folks do. So thank

22 you so much.

23 ACTING SECRETARY BEAM: Thank you.

24 MAJORITY CHAIRMAN SAYLOR: Madam Secretary, just

25 a quick reminder before I go to my comments, if you would 173

1 please get the information as requested to us as soon as

2 possible so that we can get that information out to the

3 Members of both sides of the aisle. I would appreciate

4 that.

5 ACTING SECRETARY BEAM: Absolutely, Chairman.

6 MAJORITY CHAIRMAN SAYLOR: I guess the concern I

7 have, had, is twofold with nursing homes. One, none of the

8 nursing homes, to my understanding, had received PPE, yet

9 hospitals did, and we were sending patients to nursing

10 homes that had COVID.

11 Now, I realize you weren't the Secretary at that

12 time. That's a real concern, because that's where we lost

13 so many individuals during this pandemic. And, you know,

14 when you are private industry and everybody and his brother

15 is trying to buy PPE, I would have thought that we at the

16 State would have been more helpful to the nursing homes in

17 making sure that they had the protective gear they needed,

18 and I don't know why the decision was not made to make sure

19 that nursing homes had it as well as our hospitals and

20 other nursing facilities that had to do with surgical

21 centers and so on and so forth.

22 But let me move on to another concern that I

23 think you need to understand from the taxpayers' point of

24 view, and even Members to a great degree.

25 When we in government, politicians and 174

1 bureaucrats, talk about and use government terms like

2 "skilled nursing homes," everybody believes their nursing

3 home is a skilled nursing home -- okay? -- and they don't

4 understand that. And their perception is, well, my mom or

5 my dad is in a nursing home and they didn't get it; they're

6 not being honest with us. And it's not because you are

7 lying or trying to distort things, but you are using

8 government terms that many taxpayers don't understand, and

9 that creates a real fear and a real belief that government

10 is not being honest with taxpayers and with, you know, at

11 least concerned citizens. And I think it is so important

12 for us in government and as politicians to get out of the

13 government speak and speak plain English so that we are

14 making it clear of what we are attempting to do in this

15 process.

16 You know, another thing I seen this weekend on

17 Facebook, a certain staff member in York County, a young

18 man, posted on Facebook with his little card that he had

19 gotten vaccinated, and when people do those kinds of

20 things, legislative staffers are showing their card that

21 they got vaccinated, it sends other people angry, thinking

22 here is a politician or a bureaucrat getting vaccinated and

23 he's in his 20s or 30 years old. So these are the kinds of

24 things that we in government have to be more responsible in

25 how we handle these issues. 175

1 I know you are brand new, and I really appreciate

2 it, and I really look forward to working with you. The

3 previous Secretary did not work well with the General

4 Assembly, I don't believe on either side of the aisle, as

5 I've had past discussions with Democratic Leader

6 Frank Dermody who was here last session. So we do look

7 forward to working with you, looking to the future.

8 You know, when it comes down to it, we've had so

9 many questions to you today, and I know they have been

10 tough, and you weren't there when a lot of these decisions

11 were made. It was the previous Secretary. But I just

12 wanted you to understand, Democrats and Republicans alike

13 have been getting hit very hard by constituents.

14 I walked into Rutter's this morning, and right

15 away, one of the workers, an older lady in her 70s, hit me

16 up right away that she hadn't gotten her vaccine and she

17 has been having problems getting in contact with somebody

18 to get a vaccine. So these are the kinds of things every

19 day, no matter where we go, the grocery store, Rutter's,

20 Wawa, Sheetz, whatever it is, wherever we happen to be, we

21 get hit by people who are very frustrated, which in some

22 cases makes us just as frustrated, so.

23 I'm going to apologize to you for hitting you -­

24 we have been hitting you pretty hard here for being a new

25 Secretary, but at the same time, this Administration has 176

1 got to understand what we as Legislators every day, who are

2 out there going all over the place in our own home

3 districts, are getting hit with by young people who are

4 seeing mom and dad in a nursing home not being immunized,

5 workers in certain nursing homes not being immunized, and

6 the real concern that is out there.

7 So I look forward to having a better working

8 relationship with you as the new Secretary than we had

9 previously, and more transparency from you as well. All of

10 us share, I believe, the goals that you have expressed

11 today as we move forward in getting these vaccines

12 distributed fair and getting it in people's arms and

13 getting our economy in Pennsylvania back to where it needs

14 to be for all Pennsylvanians.

15 So I want to thank you today for being here and

16 testifying and taking the tough questions as well.

17 Any final comment, Madam Secretary?

18 ACTING SECRETARY BEAM: No. Thank you for the

19 opportunity. I appreciate it. And I really do hope that

20 not only the leadership that is here today but also your

21 colleagues more broadly, I really look forward to

22 collaborating moving forward. This is absolutely a

23 Pennsylvania-wide issue, and it's going to require all of

24 us to really move forward through this pandemic.

25 So thank you for the time. 177

1 MAJORITY CHAIRMAN SAYLOR: You're welcome.

2 I do want to advise everybody as we adjourn here

3 today that we will be back here on Monday, March 1st -­

4 going into March here -- and it will be at 10 a.m., and

5 we'll be here with the Department of Education. I will

6 look forward to seeing everybody at 10 a.m. on Monday.

7 Thank you, and this hearing is adjourned.

8

9 (At 3:17 p.m., the budget hearing adjourned.) 178

1 I hereby certify that the foregoing proceedings

2 are a true and accurate transcription produced from audio

3 on the said proceedings and that this is a correct

4 transcript of the same.

5

6

7

8 Debra B. Miller

9 Transcriptionist

10 [email protected]