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 LYNDA SCHLEGEL CULVER HONORABLE TORREN C. ECKER HONORABLE JONATHAN FRITZ HONORABLE KEITH J. GREINER HONORABLE DOYLE HEFFLEY HONORABLE JOHNATHAN D. HERSHEY HONORABLE R. LEE JAMES HONORABLE JOHN A. LAWRENCE HONORABLE ZACHARY MAKO HONORABLE NATALIE MIHALEK HONORABLE TIMOTHY J. O'NEAL HONORABLE CLINT OWLETT HONORABLE CHRISTOPHER B. QUINN HONORABLE GREG ROTHMAN HONORABLE MEGHAN SCHROEDER HONORABLE JAMES B. STRUZZI II HONORABLE JESSE TOPPER
Debra B. Miller dbmreporting@msn. com 2
BEFORE (continued): HONORABLE RYAN WARNER HONORABLE JEFF C. WHEELAND HONORABLE DAVID H. ZIMMERMAN HONORABLE MATTHEW D. BRADFORD, DEMOCRATIC CHAIRMAN HONORABLE AMEN BROWN HONORABLE DONNA BULLOCK HONORABLE MORGAN CEPHAS HONORABLE AUSTIN A. DAVIS HONORABLE ELIZABETH FIEDLER HONORABLE MARTY FLYNN HONORABLE ED GAINEY HONORABLE PATTY KIM HONORABLE EMILY KINKEAD HONORABLE STEPHEN KINSEY HONORABLE LEANNE KRUEGER HONORABLE BENJAMIN V. SANCHEZ HONORABLE PETER SCHWEYER HONORABLE JOE WEBSTER
ALSO IN ATTENDANCE: HONORABLE DAN FRANKEL 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 Kathy Rapp, 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 Torren Ecker.
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