Board of Supervisors

MONTEREY COUNTY

BOARD OF SUPERVISORS

LUIS A. ALEJO, District 1 JOHN M. PHILLIPS, District 2 CHRIS M. LOPEZ, District 3 WENDY ROOT ASKEW, Chair, District 4 MARY ADAMS, Vice Chair, District 5

March 8, 2021

Tómas Aragón, M.D., Dr. P.H. Director and State Public Health Officer California Department of Public Health

Re: 1/28/21 Monterey County Board of Supervisors Letter on COVID-19 Vaccines, Data and Equity

Dear Dr. Aragón:

Thank you for your response to our January 28, 2021 letter to Governor Newsom. The County’s letter requested immediate assistance on several critical issues related to the equitable supply and distribution of COVID-19 vaccines to keep our residents safe, especially our farmworker community which has been disproportionately impacted by the pandemic.

Response to Monterey County Needs. We would like to express our appreciation for all your efforts to support communities whose makeup may look like ours. Due to the large geographic separation and barriers between our communities and the Central Valley communities referenced in your response letter we would request your insights on how CDPH plans to focus on and address the needs of Monterey County - specifically the Salinas Valley and the Central Coast. Your letter focused on other regions of California in response to Monterey County’s concerns and caused great consternation amongst our residents who remain concerned that they are still unseen and unheard by your department.

Immediate Agricultural Season Concerns. Starting this month, the County expects a large influx of seasonal farmworkers coming to the Salinas Valley from the Imperial Valley and Yuma, Arizona. Many of these workers will work in the Salinas Valley before moving on to work in the Central Valley. Because these seasonal workers are not included in the County’s population count there is no vaccine allocation for the 35,000+ seasonal workers – compounded by the problem of not having vaccine for the 30,000+ agricultural workers who reside year-round in the County.

Requests for Vaccines for Agricultural Workers. Monterey County has repeatedly sought help from every possible avenue to provide vaccine for our agricultural workforce knowing full well that not doing so severely impacts every sector of our economy, especially our communities of color. We have repeatedly sought the assistance of the Governor, our state and federal elected leaders, CDPH, FEMA, CalOES, CVS Pharmacy, and Bay Area Multi-County Entities.

Monterey County as a Leader in Protecting our Agricultural Workforce. The County and local industry have been recognized as leaders in the fight against COVID-19 with local programs that became the model for the State’s Housing for the Harvest Program, Advisory for Agricultural Worker Protection (updated version attached), and more recently adopted Agricultural Advisory Addendum on Testing (attached). Additionally, the County started a pilot Community Health Worker (CHW) Program in partnership with local trusted community based Page 2 of 2 March 8, 2021 organizations in late 2020 which has been expanded with a goal of training and deploying 100 trained CHWs to the HPI lowest quartile census tracts/zip codes and Optum testing sites to support residents impacted with COVID- 19 with accessing resources and services.

Data and Transparency. The County is still awaiting response from the State related to our questions on vaccine equity and data transparency. We are extremely concerned that this data will reveal to us that the County has been shortchanged in its vaccine allocation. If an analysis of the data on vaccine allocations between December and March shows this, we hope that the State will provide an additional vaccine allotment to make sure Monterey County receives its fair share.

Request for Special Allocation of Vaccine for Agricultural Workers. Monterey County continues to request a special allocation of vaccine for agricultural workers. The County, our hospital and health partners, and industry leaders from agriculture, hospitality and education all agree that it is imperative that we vaccinate the most at- risk for exposure who are our valued farmworkers, quickly and safely, for the wellbeing of the entire community.

Ready to Partner with the State. The County stands ready to partner with the State and other local entities to administer COVID-19 vaccines, but in order to do so, we need 1) an adequate vaccine supply; 2) an equitable distribution process across the state; 3) data and transparency about vaccine distributions; and 4) vaccine prioritization for the agricultural workforce.

On behalf of the County of Monterey, we appreciate your attention to these requests and look forward to working together to keep our communities safe. Should you have any questions, please feel free to contact Monterey County’s Director of Health Services, Elsa Jimenez at (831) 755-4526 or [email protected] for more information.

Sincerely,

Wendy Root Askew Chair, Board of Supervisors

Attachments

CC: Governor Gavin Newsom Senator Anna Caballero Senator John Laird Assemblymember Robert Rivas Assemblymember Mark Stone Congressman Jimmy Panetta U.S. Senator Dianne Feinstein U.S. Senator Alex Padilla California State Association of Counties (CSAC) Rural Counties Representative of California (RCRC) 2021 ADVISORY FOR AGRICULTURAL WORKER PROTECTION DURING COVID-19 PANDEMIC ON THE CENTRAL COAST OF CALIFORNIA Testing Addendum

Although most cases of COVID-19 are spread in residential and social situations in Monterey County, businesses and employers play a crucial role in preventing and slowing the spread both in the workplace and community. Until there is enough natural and vaccine-induced immunity in the country, testing remains essential to County of Monterey combat the virus.

Per CDC recommendations, implement testing of employees for COVID-19 into workplace preparedness, response, and control plans. For more detail, refer to: https://www.cdc.gov/coronavirus/2019-ncov/community/guidance-business-response.html

Testing Approaches Include: Monterey County o Initial testing of all workers before entering a workplace Agricultural Commissioner o Periodic testing of workers at regular intervals o Targeted testing of new workers or those returning from a prolonged absence such as medical leave, furlough, or working in another location o Some combination of approaches Monterey County Farm Bureau Several factors may help determine the intervals for periodic testing, including the availability of testing supplies, results of the previous testing, and community transmission levels.

Free Testing Sites: The County and State offer free testing at sites throughout the community available to all. Find a list on-line at https://www.co.monterey.ca.us/government/departments-a- Grower-Shipper h/administrative-office/office-of-emergency-services/response/covid-19. Association of Central California Other Testing Models: As an employer, you can also arrange for private testing for your staff. Below are businesses that local Ag employers have partnered with to provide testing for their workers.

Monterey County Vintners & Growers o On-Site Testing (locally available; there may be other providers): Association ▪ Virus Geeks : https://virusgeeks.com/about ▪ Lifeline Health: https://wearelifelinehealth.com/ ▪ ArcPoint Labs: www.arcpointlabs.com/montereybay

o Bulk-Purchase and Agreements with local health clinics (there may be others): ▪ Pinnacle Healthcare: 831-422-5555 ▪ Doctors on Duty: 831-422-7777

Coastal Growers ▪ Clinica de Salud: 831-757-6480 Association COVID-19 Information and Resources: The Agriculture trade associations and partners have established a website with information and resources to help Ag and other frontline employers more easily navigate employee California Strawberry Commission COVID education, testing, and vaccination: MontereyFrontlineCovidVaccine.com.

REVISED 2/23/2021 2021 ADVISORY FOR AGRICULTURAL WORKER PROTECTION DURING COVID-19 PANDEMIC ON THE CENTRAL COAST OF CALIFORNIA

Continuing to maintain a safe and healthy work environment for our Agricultural workers and their family members, as well as the community in general, remains a priority in the Agricultural community. While we all wait for broader distribution of vaccines, Agricultural employers strive to prevent, decrease and lower the impact of COVID-19 in our fields, workplaces, homes, and community. Food production and maintaining our national food supply chain are essential while protecting the health of County of Monterey our workers and the broader community.

These practices are based on reviews of our existing, stringent practices this group put in place early in the pandemic, aligned with the best practices offered by the Center for Disease Control (CDC), CA Department of Public Health (CDPH), World Health Organization, and public health departments.

Through this Advisory, all listed organizations support and encourage the Agricultural Monterey County Agricultural community to expeditiously implement these protective measures at their Commissioner worksites. The objectives communicated here are: preventing and reducing transmission among Agricultural workers and their families; protecting people who are at higher risk for adverse health complications; maintaining business operations;

Monterey County and, minimizing adverse effects on other entities in their supply chains, and Farm Bureau community.

TESTING • Although most cases of COVID-19 are spread in residential and social situations in Monterey County, businesses and employers play a crucial role in preventing and slowing the spread both in the workplace and community. Until there is enough Grower-Shipper natural and vaccine-induced immunity in the country, testing remains essential to Association of combat the virus. Central California • Per CDC recommendations, implement testing of employees for COVID-19 into workplace preparedness, response, and control plans. • Approaches may include: Monterey County o Initial testing of all workers before entering a workplace. Vintners & Growers o Periodic testing of workers at regular intervals. Association o Targeted testing of new workers or those returning from a prolonged absence such as medical leave, furlough, or working in another location. o Some combination of approaches. • Several factors may help determine the intervals for periodic testing, including the availability of testing supplies, results of the previous testing, and community transmission levels. • The County and State offer free testing at sites throughout the community available Coastal Growers to all; check on-line at https://www.co.monterey.ca.us/government/departments-a- Association h/administrative-office/office-of-emergency-services/response/covid-19 • Other testing models: as an employer, you can arrange for private testing for your staff. Below are businesses that local Agricultural employers have partnered with to California Strawberry provide testing for their workers: Commission o On-Site Testing (locally available; there may be others): Version 9.0 ▪ Virus Geeks: https://virusgeeks.com/about ▪ Lifeline Health: https://wearelifelinehealth.com/ PAGE 2 ▪ ArcPoint Labs: www.arcpointlabs.com/montereybay o Bulk-Purchase and Agreements with local health clinics (there may be others): ▪ Pinnacle Healthcare: 831-422-5555 ▪ Doctors on Duty: 831-422-7777 ▪ Clinica de Salud: 831-757-6480

WHAT IF AN EMPLOYEE TESTS POSITIVE FOR COVID-19? County of Monterey • Follow the directions in the Monterey County Health Dept. COVID-19 Workplace Exposure Guidance at: https://www.co.monterey.ca.us/home/showdocument?id=90872 • Require workers not to come to work if they are ill. • Inform and encourage employees to self-monitor for signs and symptoms of COVID- 19 if they suspect possible exposure. • Employees at work who develop mild symptoms of being ill should be sent home immediately with information on available resources including hotline numbers for Monterey County medical advice and social services; if symptoms are severe, employees should Agricultural Commissioner immediately call 911 and then proceed to an emergency room for treatment. The employer should provide information about self-isolation requirements and immediately conduct worksite contact tracing. Clean and disinfect all areas and surfaces that ill employees contacted. Monterey County • Educate foreman to screen and recognize COVID-19 symptoms; provide ill farm Farm Bureau employees with information about income replacement programs (sick leave), isolation facilities, and access to health care services (either insured or uninsured). • If an employee tests positive for COVID-19, the employer will be contacted by the health department. Immediate actions should be taken to protect other employees and customers and ensure transparent communication both internally and externally. Individual employee health information is protected under law. o These actions include identifying the employee’s work location (including Grower-Shipper multiple worksites, if applicable), work dates and hours, general and specific Association of work duties, and the last day the employee was at work. Identify who has had Central California contact with the employee at the worksite and during transport. o If unable to verify that the ill employee’s attending physician has contacted the public health department, and health authorities have not made direct Monterey County contact with the employer, call the health department immediately. Vintners & Growers ▪ Do not disclose the employee name unless asked to by the County Association Health Dept. o Health authorities will provide recommendations regarding the next steps in terms of identifying employees and further protective measures. o This employee should follow the direction and guidance of the health department or health professional, or state and federal guidelines regarding specific isolation and quarantine requirements. • CA Labor & Workforce Development Agency guidance for Agricultural employers: www.SaferAtWork.covid19.ca.gov Coastal Growers Association HOUSING SERVICES • Project Room Key: contact: https://www.cdss.ca.gov/inforesources/cdss- California Strawberry Commission programs/housing-programs/project-roomkey • Housing for Harvest: Food and agriculture workers who have COVID-19 or have been Version 9.0 exposed may be able to receive isolation support and stay in a free hotel room; contact: https://covid19.ca.gov/housing-for-agricultural-workers or call 831-769-8700. PAGE 3 • Wrap Around Services: Monterey County Office of Emergency Services will arrange for necessary services for isolated individuals; call 831-769-8700. • For employer provided housing, conduct training detailing site-specific and personal protective measures to safeguard against contraction and transmission of COVID-19. o This includes training upon arrival for all employees (and guest workers). o Training should be based on public health guidance from the CDC, OSHA, state, and local public health authorities, specific to COVID-19. o Train employees to respect social distancing practices (6 feet), as is feasible for the site-specific area, including but not limited to living quarters. Housing County of Monterey arrangements should be managed to maintain employee cohort integrity. o Follow CDC, DOL, and state guidelines for H-2A housing; consult with health department for isolation and housing options, if needed.

SUPPLEMENTAL WAGE REPLACEMENT • Funding is available for wage replacement for individuals unable to work due to COVID-19 exposure or diagnosis; community health workers are available to make Monterey County connections to: Building Healthy Communities and United Way. Funds are supplied Agricultural Commissioner after individual completes the isolation process (2 weeks).

EMPLOYEE TRANSPORTATION Monterey County • Bus and vanpool transportation provided by farming and harvesting operations are Farm Bureau encouraged to maintain safe distancing in seating configurations, as much as possible, that matches the social distancing guidance, making multiple trips as necessary; ensure facial coverings are utilized during transportation. • Assigned seating will help to determine exposure circles should an employee become ill. • Follow federal and state guidelines when transporting H-2A employees. • Encourage worker-directed car-pooling efforts to incorporate protective health Grower-Shipper guidance, when appropriate; encourage carpools to include only individuals who Association of Central California reside together; ensure facial coverings are utilized during carpools that do not include family or living partners.

Monterey County COVID-19 INFORMATION AND RESOURCES Vintners & Growers • The Agriculture trade associations and partners have established a website with Association information and resources to help Ag and other frontline employers more easily navigate employee COVID education, and vaccination: MontereyFrontlineCovidVaccine.com • Info for employers is also available from the Community Foundation for Monterey County at https://www.cfmco.org/impact/covid-19-collaborative/

Coastal Growers Association

California Strawberry Commission

Version 9.0 REVISED 2/23/2021 MONTEREY COUNTY

BOARD OF SUPERVISORS

LUIS A. ALEJO, District 1 JOHN M. PHILLIPS, District 2 CHRIS M. LOPEZ, District 3 WENDY ROOT ASKEW, Chair, District 4 MARY ADAMS, Vice Chair, District 5

January 28, 2021

The Honorable Gavin Newsom Governor of California State Capitol Sacramento, CA 95814

RE: COVID-19 Vaccination Requests

Dear Governor Newsom:

On behalf of the Monterey County Board of Supervisors, I write to respectfully request your immediate assistance on several critical issues related to the equitable supply and distribution of COVID-19 vaccines to keep our residents safe, especially our farmworker community which has been disproportionately impacted by the pandemic.

The Significance of Monterey County Agriculture. With an extensive farming history dating back to the 1850s, Monterey County currently grows over 150 specialty crops and exports nearly 400 billion pounds of produce from the Salinas Valley every year. Monterey County is one of the nation’s top agricultural producers. The agricultural industry is the county’s largest economic and employment sector, in 2018 generating $11.7 billion and employing 63,921 individuals. Keeping the agricultural industry and its workers safe and productive is vital to ensure the food supply of the county, state, nation and world.

Impacts on the Monterey County Economy. COVID-19 infection rates among the agricultural workforce has had devastating effects, impacting far more than the County’s agricultural industry. Due to high infection rates in the Salinas Valley, Monterey County largely has remained in the most restrictive tier of California’s Blueprint for a Safer Economy and will likely remain there unless the agricultural workforce can quickly be vaccinated. Even though infection rates in the Monterey Peninsula were significantly lower, the County’s categorization in the most restrictive Purple Tier and later shelter-in-place resulted in an estimated $1.8 billion loss to the County’s hospitality industry, thousands of lost jobs and business closures.

Concerns in Preparation for the Agricultural Season. Farmworkers are the fulcrum of the food chain. Over the past months it has become clear that our County’s infection rates are the highest among the agricultural workforce and their family members. Ensuring the health of agricultural workers is of paramount importance to ensure the health of all county residents.

- New York Times Article. Starting in March we expect a large influx of seasonal farmworkers coming to the Salinas Valley from Yuma, Arizona to work in our agricultural industry. According to a January 22, 2021 New York Times article, “… the Yuma area has identified coronavirus cases at a higher rate than any other U.S. region.” The report further states “Arizona has seen among the highest increases in newly reported deaths of any state over the past two weeks.” Page 2 of 3 January 28, 2021

- U.C. San Francisco Study. According to a new U.C. San Francisco Study, “Latino Californians experienced a 36% increase in mortality during the pandemic (RR=1.36; 95% PI: 1.29–1.44), with a 59% increase among Latino food/agriculture workers (RR=1.59; 95% PI: 1.47–1.75).” The report concludes that, “Certain occupational sectors have been associated with high excess mortality during the pandemic, particularly among racial and ethnic groups also disproportionately affected by COVID-19. In-person essential work is a likely venue of transmission of coronavirus infection and must be addressed through strict enforcement of health orders in workplace settings and protection of in-person workers. Vaccine distribution prioritizing in- person essential workers will be important for reducing excess COVID mortality.”

Inequities in Vaccine Allocation Impacting Monterey County. Monterey County has been placed at a distinct disadvantage compared to Santa Clara, Santa Cruz, and San Luis Obispo counties and other counties around the state. These factors make the calculation for distribution to Monterey County patently unfair to County residents. - Multi-County Entities (MCEs). Residents of counties with MCEs, such as those listed above, benefit from an influx of vaccines through MCEs (e.g. Kaiser, Common Spirit/Dignity, Sutter, etc.) and from the county’s allocation. While Monterey County only gets an allocation after the MCE cut has been taken off the top at the state level. - Allocations to State Prisons. The same is true for allocations to our State Prison (e.g., Soledad State Prison). - Inequities in Population County. Additionally, because the County’s seasonal agricultural workers are not included in the County’s population, there is no allocation for the estimated 35,000+ seasonal workers which migrate to the County starting in March.

Request for Special Allocation of Vaccine for Agricultural Workers. Monterey County is requesting a special allocation of vaccine for agricultural workers. The County, our hospital and health partners, and industry leaders from agriculture, hospitality and education all agree that it is imperative that we vaccinate the most at-risk for exposure who are our valued farmworkers, quickly and safely, for the wellbeing of the entire community.

Previously, the County requested that farmworkers be prioritized for receiving the COVID-19 vaccination in order to adequately keep our farmworkers safe. While this community was included in Phase 1B of the State’s initial vaccination plan, and the State is currently in that Phase, the County is not receiving an adequate amount of vaccine to quickly and effectively vaccinate this population. We request the State’s immediate assistance to supply vaccines for the current agricultural workforce population, and for the additional influx of migrant agricultural workers coming to our community starting in the next few weeks.

Data and Transparency. The County requests more transparency in the number of vaccine allocations per county to ensure we receive our fair and equitable share. It is important that the state and local health departments have a clear line of sight as to what is being allocated, received, and administered statewide so that we can identify when there are data inconsistencies and/or vaccine is not being administered in a timely manner. This will allow further investigation and identification of the challenges and will allow for more improvement of the system.

In addition, timely and accurate data supports local health departments in making key decisions at the local level. For example, because of delays with the federal pharmacy partnership, many long-term care and congregate living facilities have asked local health departments to step in and vaccinate their staff and residents. However, local health departments have no line of site as to the progress being made by CVS/Walgreens and/or how much vaccine is being distributed in their jurisdictions. In addition, multi-county entities (MCEs) have requested additional vaccine from local health departments and again, due to a lack of data transparency, it is difficult to assess whether they are being provided enough vaccine through the MCE process or whether the MCE’s allocation Page 3 of 3 January 28, 2021 process needs to be reevaluated. Prisons are also receiving vaccines that are counted as part of the overall County share of doses.

Monterey County is Ready with Plans, Capacity and Partnerships. The County stands ready to partner with the State to assist in the distribution and administration of the COVID-19 vaccine. We have detailed plans in place (Monterey County Health Department Strategy for Implementing California's COVID-19 Vaccination Plan) to achieve this including strong partnerships with local entities, hospitals and health care providers, large employers (e.g., The Pebble Beach Company) – and specifically in the agriculture community with the Grower- Shipper Association of Central California, D’Arrigo and Taylor Farms. All of which are ready to stand-up vaccination sites prioritizing those with occupational risk exposure and residing in vulnerable communities as determined by the California Healthy Places Index. The County’s plan can be easily scaled as we receive larger amounts of vaccine. Additionally, we request state and federal support to scale up mass vaccination sites, as have been coordinated in other areas of the State.

Local Support. The County has received overwhelming local support from our cities, hospitality industry, health care partners, and education community to assist the agriculture community as quickly and efficiently as possible. The Monterey County Board of Supervisors recently received letters from the Monterey County Hospitality Association, as well as from the Mayors of Carmel-by-the-Sea, Del Rey Oaks, Marina, Monterey, Pacific Grove, Salinas, Sand City, and Seaside urging COVID-19 testing and vaccinations for the agriculture community.

On behalf of the County of Monterey, we appreciate your consideration of our requests and look forward to working together to keep our communities safe. Should you have any questions, please feel free to contact Senior Policy Advisor, Ashley Walker of Nossaman LLP at 916-442-8888.

Sincerely,

Wendy Root Askew Chair, Board of Supervisors

CC: Hon. Anna Caballero, 12th Senate District Hon. John Laird, 17th Senate District Hon. Robert Rivas, 30th Assembly District Hon. Mark Stone, 29th Assembly District California State Association of Counties (CSAC) Rural Counties Representative of California (RCRC) MONTEREY COUNTY

BOARD OF SUPERVISORS LUIS A. ALEJO, District 1 JOHN M. PHILLIPS, District 2 CHRIS M. LOPEZ, District 3 WENDY ROOT ASKEW, Chair, District 4 MARY ADAMS, Vice Chair, District 5

February 3, 2021

Ms. Karen S. Lynch President and CEO CVS Health One CVS Drive Woonsocket, RI 02895

Re: CVS COVID-19 Vaccine Locations in Monterey County

Dear Ms. Lynch:

On behalf of the Monterey County Board of Supervisors, I am writing to express our concern over the decision by CVS Health not to allocate initial allotments of limited COVID-19 vaccine to CVS Health Pharmacy locations in Monterey County that are the most accessible to our most vulnerable residents.

As you know, the Center for Disease Control’s Federal Retail Pharmacy Program for COVID-19 Vaccination (“the Program”) is a collaboration between the federal government, pharmacy partners and states to increase access to COVID-19 vaccination across the United States. We support the Program, but we believe it must be administered equitably to ensure it does not exacerbate the alarming trend we are seeing in the County and across the country of COVID-19 spreading through communities of color at higher rates.

In recent comments to the media about the Program, White House Coordinator of the COVID-19 Response, Jeff Zients, stated “the Centers for Disease Control, which has quite a bit of experience working with pharmacies, is making sure that we are picking pharmacies in that first phase that are located in areas that are harder to reach to ensure that we have equitable distribution of the pharmacy doses.” Similarly, the California Department of Public Health’s revised guidelines for allocation of COVID-19 vaccine directs providers to prioritize and target outreach to older persons living “in vulnerable communities, as determined by the California Healthy Places Index or comparable local health department knowledge, to address equity and communities disproportionately affected by the pandemic.” We couldn’t agree more.

In your press release announcing CVS’s participation in the Program, you state that CVS is an “ideal partner for administering vaccines in a safe, convenient, and familiar manner” and that “[t]his is particularly true for underserved communities, which have been a focus for us throughout the pandemic.” If that is the case, we would gladly work with you and your team to identify other CVS Pharmacy locations that can administer vaccinations in areas of the County with the highest rates of infection, hospitalization and death, such as the City of Salinas and cities in Southern Monterey County where multigenerational housing and other factors put these communities at higher risk.

Monterey County’s Vaccination Plan. Under California’s COVID-19 Vaccination Plan, Monterey County is currently vaccinating Phase 1a and Phase 1b for those 75 years of age and older. However, the County’s current vaccine supply is nowhere near able to meet the needs of our community. For this reason, the County requests that CVS allocate as much vaccine to CVS locations within Monterey County as possible.

Clerk of the Board • 168 W. Alisal St., Salinas, CA 93901 • (831) 755-5066 • [email protected] Page 2 of 2 Ms. Karen Lynch, President & CEO CVS Health February 3, 2021

Comparison of COVID-19 Incidence Rates in Monterey County. The chart below shows the January 2021 COVID-19 incidence rates in several Monterey County zip codes. The CVS sites selected to receive vaccine are in Monterey (93940) and Carmel (93923), which are experiencing a relatively low incidence rate. By comparison, the cities of Soledad (93960) and Salinas (93905 and 93906) are experiencing COVID-19 incidence rates 3-4 times higher than in Monterey and 6-7 times higher than in Carmel. The situation is similar in Soledad (93955) and worse in King City (93930) and Greenfield (93927).

January Incidence Rate Zip Code City per 100,000 Population 93940 Monterey 26.7 93923 Carmel 13.5 93960 Soledad 81.2 93905 Salinas 101.7 93906 Salinas 84.1 93927 Greenfield 123.5 93930 King City 104.6 93955 Soledad 73.1

CVS Locations in High COVID-19 Incidence Rate Communities. By selecting CVS locations to receive vaccines which are in zip codes with higher incidence rates our community would be better served both from an equity and disease control perspective. CVS has locations in both Soledad and Salinas. Monterey County urges CVS to allot vaccine to the CVS Pharmacy y más locations at 347 East Alisal Street in Salinas and 2293 H Dela Rosa Street in Soledad, as these locations are better situated to serve both Salinas and South County residents in the higher incidence zip codes.

We look forward to working with you to develop an equitable rollout of this important new program so that it quickly reaches the people who are suffering the most and who have been disparately impacted by the COVID-19 pandemic.

Sincerely,

Wendy Root Askew Chair, Board of Supervisors

Cc: Governor Gavin Newsom U.S. Senator Dianne Feinstein U.S. Senator Alex Padilla Rep. Jimmy Panetta, 20th Congressional District Hon. Anna Caballero, 12th Senate District Hon. John Laird, 17th Senate District Hon. Mark Stone, 29th Assembly District Hon. Robert Rivas, 30th Assembly District CDC Director, Rochelle P. Walensky, MD, MPH HHS Acting Secretary, Norris Cochran California State Association of Counties (CSAC) Rural County Representatives of California (RCRC) National Association of Counties (NACo) COUNTY OF MONTEREY HEALTH DEPARTMENT Elsa Jimenez, Director of Health Oinic Services Administration Emergency Medical Services Public Health Behavioral Health Environmental Health/Animal Services Public Administrator/Public Guardian Nationally Accredited for Providing Quality Health Services

February 23, 2021

Tomas J. Aragon, MD, DrPH Director & State Public Health Officer California Department of Public Health PO Box 997377, MS 0500 Sacramento, CA 95899-7377

Dear Dr. Aragon:

I am requesting that the California Department of Public Health (CDPH) take into consideration the influx of migrant, seasonal and temporary agriculture workers to Monterey County and that CDPH increase Monterey County's future allocations to assist Monterey County in vaccinating this essential workforce.

According to the American Community Survey 2019 5-Year Estimate, 32,707 individuals work in agriculture and related industries in Monterey County. As reported in industry sector data provided by CDPH, 35,330 individuals are employed in agriculture and related industries. However, according to the Farmworker Housing Study and Action Plan for Salinas Valley and Pajaro Valley April 2018, an estimated 91,433 agricultural workers were employed in the region during 2016. Of these 91,433 farmworkers, approximately 20%, or 18,300 are migrant or seasonal/temporary, non-permanent residents. Of those, more than 4,600 are H-2A visa workers. Furthermore, according to the Economic Contributions of Monterey County Agriculture Annual Report published by the Office of the Monterey County Agricultural Commissioner, 63,921 agricultural workers were employed in 2018, and according to our Commissioner, 35,000 are seasonal/temporary workers of which an estimated 20,000 are H-2A visa workers.

Last year, this population was disproportionately impacted by COVID-19. In 2020, at the peak of the first pandemic wave, 46% of confirmed cases for which sector information was available were employed in Agriculture. In response, Monterey County Health Department in collaboration with numerous other agencies implemented a variety of strategies to slow the spread of COVID-19. These strategies include the Alternative Housing Program for those that cannot isolate safely, food assistance, stipends to offset lost wages, legal advice, and access to various social support programs.

Now that vaccine is available, our Health Department and other local vaccine providers are eager to vaccinate our local farmworkers and migrant, seasonal and temporary farmworkers. However, based on observations, prior allocation formulas appear to have favored counties served by Multicounty Entities (MCE). Since Monterey County is not served by an MCE, we lag neighboring counties in our efforts to vaccinate our residents, including agriculture workers. Furthermore, State COVID-19 vaccine allocation formulas do not account for migrant, seasonal and temporary farm workers arriving in Monterey County.

1270 Natividad Road, Salinas, CA 93906 831-755-4500 www.mtyhd.org February 23, 2021 Page 2 of 2

I request that CDPH take into consideration the agricultural workers that are arriving in Monterey County which are not included in state allocation formula and that CDPH increase our allocation accordingly.

I appreciate your consideration of this request.

Respectfully,

E ward Moreno, MD, MPH ea Ith Officer and Director of Public Health Phone: 831-755-4585 Email: [email protected]

1270 Natividad Road, Salinas, CA 93906 831-755-4500 www.mtyhd.org MONTEREY COUNTY

BOARD OF SUPERVISORS LUIS A. ALEJO, District 1 JOHN M. PHILLIPS, District 2 CHRIS M. LOPEZ, District 3 WENDY ROOT ASKEW, Chair, District 4 MARY ADAMS, Vice Chair, District 5

February 25, 2021 Ms. Sarah Kravens Mr. Stephen Gray President/CEO Chief Administrator, Operations Executive Sutter Health Sutter Health – Santa Cruz County 2200 River Plaza Drive 2900 Chanticleer Avenue Sacramento, CA 95833 Santa Cruz, CA 95065

RE: Invitation for Bay Area Multi-County Entities (MCEs) to Host Vaccine Clinics for Farmworkers Dear Ms. Kravens and Mr. Gray: On behalf of the Monterey County Board of Supervisors, I write to respectfully request your assistance in supporting and/or operating COVID-19 vaccination clinics for agricultural workers in Monterey County who have been disproportionately impacted by the pandemic. The Significance of Monterey County Agriculture. With an extensive farming history dating back to the 1850s, Monterey County currently grows over 150 specialty crops and exports nearly 400 billion pounds of produce from the Salinas Valley every year. Monterey County is one of the nation’s top agricultural producers. The agricultural industry is the county’s largest economic and employment sector, in 2018 generating $11.7 billion and employing 63,921 individuals. Keeping the agricultural industry and its workers safe and productive is vital to ensure the food supply of the county, state, nation and world. Impacts on the Monterey County Economy. COVID-19 infection rates among the agricultural workforce has had devastating effects, impacting far more than the County’s agricultural industry. Due to high infection rates in the Salinas Valley, Monterey County largely has remained in the most restrictive tier of California’s Blueprint for a Safer Economy and will likely remain there unless the agricultural workforce can quickly be vaccinated. Even though infection rates in the Monterey Peninsula were significantly lower, the County’s categorization in the most restrictive Purple Tier and later shelter-in-place orders resulted in an estimated $1.8 billion loss to the County’s hospitality industry, thousands of lost jobs and business closures. Disproportionate Impacts to Monterey County Farmworker Community: Over the past several months it has become clear that our County’s infection rates are the highest among the agricultural workforce and their family members. Among individuals diagnosed with COVID-19 in Monterey County who self-report their occupation, currently 19% are employed in the agriculture industry. During the spring and summer growing season, it was approximately 40%. As I am sure you are aware, farmworkers are overwhelmingly people of color and people of color are also disproportionately impacted by Covid-19. Latinos account for 86% of Monterey County COVID-19 cases for which racial and ethnic information is known. Latinos are also disproportionately burdened by severe disease, representing 77% of local hospitalizations and 62% of fatalities. Inequities in Vaccine Allocation Impacting Monterey County. Monterey County has been placed at a distinct disadvantage compared to neighboring Santa Clara, Santa Cruz, and San Luis Obispo counties and other counties around the state. Two major factors are contributing to this situation:

Clerk of the Board • 168 W. Alisal St., Salinas, CA 93901 • (831) 755-5066 • [email protected] Page 2 of 3 February 25, 2021

1. There are no Multi-County Entities (MCEs) Operating in Monterey County. Residents of counties with MCEs, such as those listed above, benefit from an influx of vaccines through MCEs separate from the county’s allocation. In contrast, Monterey County only gets an allocation after the MCE cut has been taken off the top at the state level.

2. Inequities in Population Count. Because the County’s seasonal agricultural workers are not included in the County’s population, there is no vaccine allocation for the estimated 35,000+ seasonal workers. This fact compounds the inequitable distribution of vaccine to Monterey and farmworkers. Immediate Concerns in Preparation of the Agricultural Season. Starting in March the County expects a large influx of seasonal farmworkers coming to the Salinas Valley from Yuma, Arizona. According to a January 22, 2021 New York Times article, “… the Yuma area has identified coronavirus cases at a higher rate than any other U.S. region.” The report further states “Arizona has seen among the highest increases in newly reported deaths of any state over the past two weeks.” Additionally, according to a new U.C. San Francisco Study, “Latino Californians experienced a 36% increase in mortality during the pandemic (RR=1.36; 95% PI: 1.29–1.44), with a 59% increase among Latino food/agriculture workers (RR=1.59; 95% PI: 1.47–1.75).” The report concludes that, “Certain occupational sectors have been associated with high excess mortality during the pandemic, particularly among racial and ethnic groups also disproportionately affected by COVID-19. In-person essential work is a likely venue of transmission of coronavirus infection and must be addressed through strict enforcement of health orders in workplace settings and protection of in-person workers. Vaccine distribution prioritizing in-person essential workers will be important for reducing excess COVID mortality.” Monterey County’s Request and Invitation. For these reasons, Monterey County requests immediate assistance from the MCEs operating within the Bay Area to partner with the County. The assistance we seek could come in the form of reallocating vaccine from your system’s allocation to local healthcare systems that are prepared to operate dedicated clinics for our farmworkers. Alternatively, we would welcome dedicated clinics operated by your entity. By helping to serve the farmworker community in Monterey County, you would be helping the State and the nation by ensuring this community can continue to safely provide food security to hundreds of millions of Americans. Support for Farmworker Vaccinations: The County, our local hospitals and health partners, and industry leaders from agriculture, hospitality and education all agree that it is imperative that we vaccinate the most at-risk for exposure who are our valued farmworkers, quickly and safely, for the wellbeing of the entire community. Previously, the County requested that farmworkers be prioritized for receiving the COVID-19 vaccination in order to adequately keep our farmworkers safe. While this community was included in Phase 1B of the State’s initial vaccination plan, and the State is currently in that Phase, the County has not received an enhanced allocation to address this at-risk population and is not receiving an adequate amount of vaccine to quickly and effectively vaccinate this population. We hope you will consider partnering with Monterey County to help provide immediate assistance to supply vaccines and clinics for the current agricultural workforce population, and for the additional influx of migrant agricultural workers coming to our community starting in the next few weeks. Ensuring the health of agricultural workers is of paramount importance to ensure the health of all county residents and a food supply to the State and nation. Thank you for your consideration. Please contact Monterey County’s Director of Health Services, Elsa Mendoza Jimenez at (831) 755-42425 or [email protected] for more information. Sincerely,

Wendy Root Askew Chair, Board of Supervisors Clerk of the Board • 168 W. Alisal St., Salinas, CA 93901 • (831) 755-5066 • [email protected] Page 2 of 3 February 25, 2021

Cc: Dr. Mark Ghaly, Secretary, California Health and Human Services Agency Paul Markovich, CEO, Blue Shield of California Hon. Gavin Newsom, Governor, State of California Hon. Anna Caballero, 12th Senate District Hon. John Laird, 17th Senate District Hon. Mark Stone, 29th Assembly District Hon. Robert Rivas, 30th Assembly District California State Association of Counties (CSAC) Rural County Representatives of California (RCRC) Rep. Jimmy Panetta, 20th Congressional District U.S. Senator Dianne Feinstein U.S. Senator Alex Padilla Dr. Gary Gray, CEO, Natividad Dr. Steven Packer, President/CEO, Montage Health Pete Delgado, President/CEO, Salinas Valley Memorial Healthcare System

Clerk of the Board • 168 W. Alisal St., Salinas, CA 93901 • (831) 755-5066 • [email protected] MONTEREY COUNTY

BOARD OF SUPERVISORS LUIS A. ALEJO, District 1 JOHN M. PHILLIPS, District 2 CHRIS M. LOPEZ, District 3 WENDY ROOT ASKEW, Chair, District 4 MARY ADAMS, Vice Chair, District 5

February 25, 2021 Mr. Lloyd H. Dean Ms. Nanette Mickiewicz President/CEO President Dignity Health Dignity Health 185 Berry Street, Suite 300 1555 Soquel Drive San Francisco, CA 94107 Santa Cruz, CA 95065

Ms. Shelly Schlenker SVP Public Policy, Advocacy & Government Relations CommonSpirit Health 3400 Data Drive Rancho Cordova, CA 95620

RE: Invitation for Bay Area Multi-County Entities (MCEs) to Host Vaccine Clinics for Farmworkers Dear Mr. Dean, Ms. Mickiewicz and Ms. Schlenker: On behalf of the Monterey County Board of Supervisors, I write to respectfully request your assistance in supporting and/or operating COVID-19 vaccination clinics for agricultural workers in Monterey County who have been disproportionately impacted by the pandemic. The Significance of Monterey County Agriculture. With an extensive farming history dating back to the 1850s, Monterey County currently grows over 150 specialty crops and exports nearly 400 billion pounds of produce from the Salinas Valley every year. Monterey County is one of the nation’s top agricultural producers. The agricultural industry is the county’s largest economic and employment sector, in 2018 generating $11.7 billion and employing 63,921 individuals. Keeping the agricultural industry and its workers safe and productive is vital to ensure the food supply of the county, state, nation and world. Impacts on the Monterey County Economy. COVID-19 infection rates among the agricultural workforce has had devastating effects, impacting far more than the County’s agricultural industry. Due to high infection rates in the Salinas Valley, Monterey County largely has remained in the most restrictive tier of California’s Blueprint for a Safer Economy and will likely remain there unless the agricultural workforce can quickly be vaccinated. Even though infection rates in the Monterey Peninsula were significantly lower, the County’s categorization in the most restrictive Purple Tier and later shelter-in-place orders resulted in an estimated $1.8 billion loss to the County’s hospitality industry, thousands of lost jobs and business closures. Disproportionate Impacts to Monterey County Farmworker Community: Over the past several months it has become clear that our County’s infection rates are the highest among the agricultural workforce and their family members. Among individuals diagnosed with COVID-19 in Monterey County who self-report their occupation, currently 19% are employed in the agriculture industry. During the spring and summer growing season, it was approximately 40%. As I am sure you are aware, farmworkers are overwhelmingly people of color and people of color are also disproportionately impacted by Covid-19. Latinos account for 86% of Monterey County COVID-19

Clerk of the Board • 168 W. Alisal St., Salinas, CA 93901 • (831) 755-5066 • [email protected] Page 2 of 3 February 25, 2021 cases for which racial and ethnic information is known. Latinos are also disproportionately burdened by severe disease, representing 77% of local hospitalizations and 62% of fatalities. Inequities in Vaccine Allocation Impacting Monterey County. Monterey County has been placed at a distinct disadvantage compared to neighboring Santa Clara, Santa Cruz, and San Luis Obispo counties and other counties around the state. Two major factors are contributing to this situation: 1. There are no Multi-County Entities (MCEs) Operating in Monterey County. Residents of counties with MCEs, such as those listed above, benefit from an influx of vaccines through MCEs separate from the county’s allocation. In contrast, Monterey County only gets an allocation after the MCE cut has been taken off the top at the state level.

Clerk of the Board • 168 W. Alisal St., Salinas, CA 93901 • (831) 755-5066 • [email protected] Page 2 of 3 February 25, 2021

Thank you for your consideration. Please contact Monterey County’s Director of Health Services, Elsa Mendoza Jimenez at (831) 755-42425 or [email protected] for more information. Sincerely,

Wendy Root Askew Chair, Board of Supervisors

Clerk of the Board • 168 W. Alisal St., Salinas, CA 93901 • (831) 755-5066 • [email protected] MONTEREY COUNTY

BOARD OF SUPERVISORS LUIS A. ALEJO, District 1 JOHN M. PHILLIPS, District 2 CHRIS M. LOPEZ, District 3 WENDY ROOT ASKEW, Chair, District 4 MARY ADAMS, Vice Chair, District 5

February 25, 2021 Mr. Gregory A. Adams William MacLean, MD CEO/Chairman Physician in Charge Kaiser Permanente Kaiser Permanente Santa Cruz County 1 Kaiser Plaza 5615 Scotts Valley Drive Oakland, CA 94612 Scotts Valley, CA 95066

RE: Invitation for Bay Area Multi-County Entities (MCEs) to Host Vaccine Clinics for Farmworkers Dear Mr. Adams and Dr. MacLean: On behalf of the Monterey County Board of Supervisors, I write to respectfully request your assistance in supporting and/or operating COVID-19 vaccination clinics for agricultural workers in Monterey County who have been disproportionately impacted by the pandemic. The Significance of Monterey County Agriculture. With an extensive farming history dating back to the 1850s, Monterey County currently grows over 150 specialty crops and exports nearly 400 billion pounds of produce from the Salinas Valley every year. Monterey County is one of the nation’s top agricultural producers. The agricultural industry is the county’s largest economic and employment sector, in 2018 generating $11.7 billion and employing 63,921 individuals. Keeping the agricultural industry and its workers safe and productive is vital to ensure the food supply of the county, state, nation and world. Impacts on the Monterey County Economy. COVID-19 infection rates among the agricultural workforce has had devastating effects, impacting far more than the County’s agricultural industry. Due to high infection rates in the Salinas Valley, Monterey County largely has remained in the most restrictive tier of California’s Blueprint for a Safer Economy and will likely remain there unless the agricultural workforce can quickly be vaccinated. Even though infection rates in the Monterey Peninsula were significantly lower, the County’s categorization in the most restrictive Purple Tier and later shelter-in-place orders resulted in an estimated $1.8 billion loss to the County’s hospitality industry, thousands of lost jobs and business closures. Disproportionate Impacts to Monterey County Farmworker Community: Over the past several months it has become clear that our County’s infection rates are the highest among the agricultural workforce and their family members. Among individuals diagnosed with COVID-19 in Monterey County who self-report their occupation, currently 19% are employed in the agriculture industry. During the spring and summer growing season, it was approximately 40%. As I am sure you are aware, farmworkers are overwhelmingly people of color and people of color are also disproportionately impacted by Covid-19. Latinos account for 86% of Monterey County COVID-19 cases for which racial and ethnic information is known. Latinos are also disproportionately burdened by severe disease, representing 77% of local hospitalizations and 62% of fatalities. Inequities in Vaccine Allocation Impacting Monterey County. Monterey County has been placed at a distinct disadvantage compared to neighboring Santa Clara, Santa Cruz, and San Luis Obispo counties and other counties around the state. Two major factors are contributing to this situation:

Clerk of the Board • 168 W. Alisal St., Salinas, CA 93901 • (831) 755-5066 • [email protected] Page 2 of 3 February 25, 2021

Wendy Root Askew Chair, Board of Supervisors Clerk of the Board • 168 W. Alisal St., Salinas, CA 93901 • (831) 755-5066 • [email protected] Page 2 of 3 February 25, 2021

Clerk of the Board • 168 W. Alisal St., Salinas, CA 93901 • (831) 755-5066 • [email protected] MONTEREY COUNTY

BOARD OF SUPERVISORS LUIS A. ALEJO, District 1 JOHN M. PHILLIPS, District 2 CHRIS M. LOPEZ, District 3 WENDY ROOT ASKEW, Chair, District 4 MARY ADAMS, Vice Chair, District 5

March 2, 2021

Robert J. Fenton Mark S. Ghilarducci Acting Administrator Director Federal Emergency Management Agency California Governor’s Office of Emergency Services 500 C Street, SW 3650 Schriever Avenue Washington, DC 20472 Mather, California 95655-4203

Re: Request for COVID-19 Vaccine and Mobile Vaccine Clinics for Farmworkers in Monterey County

Dear Administrator Fenton and Director Ghilarducci:

On behalf of the Monterey County Board of Supervisors, I write to respectfully request the assistance of FEMA and CalOES in providing COVID-19 vaccines and supporting and/or operating COVID-19 mobile vaccination clinics in Monterey County. The County can utilize any combination of the Janssen (pending CDPH guidance on priority sectors/populations), Moderna, and/or Pfizer vaccine.

Monterey County’s Vaccination Plan. Under California’s COVID-19 Vaccination Plan, Monterey County is currently vaccinating California’s Phase 1a and Phase 1b populations: those 65 years of age and older as well as individuals who work in the industry sectors of food and agriculture, education and childcare and emergency services. Monterey County is placing special emphasis on those residing in ZIP codes of the greatest need utilizing California Healthy Places Index data. In addition, starting March 3, 2021, individuals who work in the industry sectors of food and agriculture, education and childcare and emergency services, and those 65 and older will be eligible for vaccine. However, the County’s current vaccine supply is nowhere near able to meet the needs of the community and is compounded by the start of the agricultural season and the reopening of schools.

Monterey County is one of the most impacted counties in California by COVID-19. Monterey County currently ranks 9th highest among California counties in COVID-19 case rates and 13th highest for test positive rates. Case rates among residents of ZIP codes with historically poorer health outcomes in Monterey County are two to three times higher than that of more affluent areas of the region. By providing vaccine in locations which are in ZIP codes with higher incidence rates our community and region would be better served both from an equity and disease control perspective.

Health Care Deserts and Hard-to-Reach Communities. The County’s goal is to immediately provide vaccinations in areas with the highest rates of infection, hospitalization and death, such as cities in southern Monterey County where multigenerational housing and other factors put these communities at higher risk. Reaching these communities poses challenges, especially in areas of the County that can be classified as “health care deserts”. The philosophy embraced by the State of getting vaccine out as quickly as possible has disenfranchised harder to engage communities that have to overcome challenges such as lack of transportation, lack of internet access, and language barriers.

Clerk of the Board • 168 W. Alisal St., Salinas, CA 93901 • (831) 755-5066 • [email protected] Page 2 of 3 March 2, 2021

Deployment of Mobile Vaccination Sites in Hard-to-Reach Communities. The County’s goal is to administer vaccine quickly and equitably to ensure it does not exacerbate the alarming trend we are seeing in the County and across the nation of COVID-19 spreading through communities of color. With FEMA/CalOES assistance, the County would strategically deploy COVID-19 mobile vaccination sites to employer sponsored housing sites and work locations and hard-to-reach areas of the County to reach agriculture workers and other frontline essential workers. Additionally, the County aims to deploy these mobile sites to neighborhoods impacted by high rates of COVID-19 in partnership with local faith-based and community-based organizations. By taking these actions we hope to protect our vulnerable year-round and seasonal agricultural workers, other harder to reach essential workers in the food, education and early childcare industries, and support the key drivers of our local economy.

The Significance of Monterey County Agriculture. With an extensive farming history dating back to the 1850s, Monterey County currently grows over 150 specialty crops and exports nearly 400 billion pounds of produce from the Salinas Valley every year. Monterey County is one of the nation’s top agricultural producers. The agricultural industry is the County’s largest economic and employment sector, in 2018 generating $11.7 billion and employing 63,921 individuals. Keeping the agricultural industry and its workers safe and productive is vital to ensure the food supply of the county, state, nation and world.

Impacts on the Monterey County Economy. COVID-19 infection rates among the agricultural workforce has had devastating effects, impacting far more than the County’s agricultural industry. Due to high infection rates in the Salinas Valley, Monterey County largely has remained in the most restrictive tier of California’s Blueprint for a Safer Economy and will likely remain there unless the agricultural workforce can quickly be vaccinated. Even though infection rates in the Monterey Peninsula were significantly lower, the County’s categorization in the most restrictive Purple Tier and later State Regional Stay-At-Home Orders resulted in an estimated $1.8 billion loss to the County’s hospitality industry, thousands of lost jobs and business closures.

Disproportionate Impacts to Monterey County Farmworker Community. Over the past several months it has become clear that our County’s infection rates are the highest among the agricultural workforce and their family members. Among individuals diagnosed with COVID-19 in Monterey County who self-report their occupation, currently 19% are employed in the agriculture industry. During the spring and summer growing season, it was approximately 40%. Latinos account for 86% of Monterey County COVID-19 cases for which racial and ethnic information is known. Latinos are also disproportionately burdened by severe disease, representing 77% of local hospitalizations and 62% of fatalities.

Inequities in Vaccine Allocation Impacting Monterey County. Monterey County has been placed at a distinct disadvantage compared to neighboring Santa Clara, Santa Cruz, and San Luis Obispo counties and other counties around the state. Two major factors are contributing to this situation:

2. Inequities in Population Count. Immigrants comprise over 30% of the total County population, and at 21.7% Monterey County has the highest percentage of non-citizens of any California County. Because the County’s seasonal agricultural workers are not included in the County’s population, there is no vaccine allocation for the estimated 35,000+ seasonal workers.

Clerk of the Board • 168 W. Alisal St., Salinas, CA 93901 • (831) 755-5066 • [email protected] Page 3 of 3 March 2, 2021

Immediate Concerns in Preparation of the Agricultural Season and Opening of Schools. Starting this month, the County expects a large influx of seasonal farmworkers coming to the Salinas Valley from the Imperial Valley and Yuma, Arizona. In late January it was reported that the Yuma area had identified coronavirus cases at a higher rate than any other U.S. region. Additionally, according to a UC San Francisco study, Latino Californians experienced a 36% increase in mortality during the pandemic, with a 59% increase among Latino food/agriculture workers. The report concluded that vaccine distribution prioritizing in-person essential workers will be important for reducing excess COVID mortality.

Monterey County’s Request and Invitation. For these reasons, Monterey County requests immediate assistance from FEMA and CalOES to partner with the County. The assistance we seek could come in the form of COVID-19 vaccines and mobile vaccine clinics that are located in hard to reach areas of the County near our farmworker communities. Alternatively, we would welcome dedicated clinics operated by your entity. By helping to serve the farmworker community in Monterey County, you would be helping the State and the Nation by ensuring this community can continue to safely provide food security to hundreds of millions of Americans.

Thank you for your consideration. Please contact Monterey County’s Director of Health Services, Elsa Mendoza Jimenez at (831) 755-4526 or [email protected] for more information.

Sincerely,

Wendy Root Askew Chair, Board of Supervisors

Cc: Hon. Gavin Newsom, Governor, State of California Hon. Anna Caballero, 12th Senate District Hon. John Laird, 17th Senate District Hon. Mark Stone, 29th Assembly District Hon. Robert Rivas, 30th Assembly District California State Association of Counties (CSAC) Rural County Representatives of California (RCRC) Rep. Jimmy Panetta, 20th Congressional District U.S. Senator Dianne Feinstein U.S. Senator Alex Padilla

Clerk of the Board • 168 W. Alisal St., Salinas, CA 93901 • (831) 755-5066 • [email protected] January 14, 2021

Honorable Governor Gavin Newsom State of California State Capitol Sacramento, CA 95814

Re: Vaccinations for farmworkers: Pilot Project

Dear Governor Newsom:

I write to urge your administration to authorize a pilot project, to develop and implement a vaccination strategy for the farmworker community in key geographical areas of the State. I write with experience as a former state agency director and in concert with five legislative colleagues: Senators Melissa Hurtado and Ben Hueso, and Assembly Members Robert Rivas, Eduardo Garcia, and Jim Frazier.

The scientific and medical consensus to control the rampant COVID pandemic is to vaccinate as many people as fast as possible. We know the logistics are daunting, which is why we propose a pilot project partnership in select farmworker communities that are the most vulnerable and most likely to communicate infection unknowingly.

Unique factors affect vaccinating the farmworkers community within the current structures available. The constant demonizing of immigrants by President Trump has intensified fear and suspicion among farmworkers, which has highlighted the association between government and ICE, rather than government and health care. Another barrier to vaccinating this population is the cultural and language diversity among them, which affects outreach, testing, and vaccinations in this largely rural population. Additionally, dense often-substandard housing precludes the option to quarantine for those testing positive, making timely vaccinations all the more vital. Farmworkers are the fulcrum of the food chain, ravaged by COVID-19 with no available replacement labor pool. Therefore, we ask for an executive order authorizing a pilot project through state and private partnership in the following locations:

Parlier, San Joaquin, Arvin, Los Baños, Soledad, Coachella and its unincorporated areas, Brawley, Calexico and El Centro, chosen for their sociocultural challenges and transmission rates. We as Legislators would partner with Administration staff and the California Retailers, to use pharmacies to deliver the vaccination. Pharmacies have the public’s trust, already give influenza shots, and have the best logistical infrastructure to deliver vaccines in these rural locations. Stationary locations could also be utilized, such as religious and community locations, as well as mobile clinics, which can be set up next to agricultural jobsites to offer convenient and secure access to the vaccine.

Together, we would plan an inoculation delivery system for each city. As your administration “certifies” other suitable professionals, we can immediately integrate them into this deliver system.

If the pilot proves effective, it would be scalable for adaption in regions throughout the state. However, given what we know about our constituencies, this pilot is the best means to vaccinate thousands of the most at-risk farmworkers, quickly and safely. All Californians are pandemic weary and in need of hope and relief. We fervently believe this pilot partnership will help accomplish those ends.

Thank you for your consideration of this request. If you are amendable to assisting in making this pilot project a reality, or should you have any questions, please feel free to reach me or my Chief of Staff, Aracely Campa Ramirez, at 916-508-7115, or [email protected].

Respectfully,

______Anna M. Caballero Melissa Hurtado Senator, 12th District Senator, 14th District ______Ben Hueso Robert Rivas Senator, 40th District Assemblymember, 30th District

______Jim Frazier Eduardo Garcia Assemblymember, 11th District Assemblymember, 56th District

Dear Madam Chair Root-Askew and Members of the Board of Supervisors,

In 2020, it is estimated our Monterey County Hospitality Industry lost $1.8 billion dollars. Thousands of jobs have been lost, businesses have been forced to close and our employees have been forced to rely on food banks and a variety of donations provided by our local non-profits and generous private citizens.

Our industry is taxed and generates a significant amount of revenue. The estimated tax loss for 2020 in Monterey County is $120 million dollars. As you know, those dollars go to the county and cities to fund police, fire, libraries, non-profits and so much more. The challenges we face today as a community are far greater than the economic impacts to our industry.

Over the course of the next six weeks, a large influx of farmworkers will return to Monterey County from Yuma, Arizona. No other region in the entire country has had a higher case rate during the pandemic. (See attached article from the New York Times)

We need the county to work with our agricultural industry and provide free testing for all returning farm workers. The community has gone to great lengths to set up housing for people to isolate and payment programs to ensure that they are paid while they isolate. We realize you cannot force people to be tested, but an organized free testing program is simply the right thing to do.

We cannot afford to have another surge in Monterey County. More importantly, we owe it to our hardest working people to do our very best to protect them, their families and our greater community.

It is going to take time for vaccines to arrive to our county and for mass vaccine distribution to occur. It is critical we have a plan in place prior to the arrival of the vaccines. To date the pandemic has been controlling us, it is time for us to take control of the pandemic. When we distribute vaccines, we urge you to rapidly implement the plan to target agricultural and food workers in zip codes that have the highest infection rate, along with the age group of 65 and above.

Our industry cannot survive another shut down, nor can our community survive without the tax revenues generated by our industry. We thank you for your prior collaborations such as grant money set aside for our small businesses. Sadly, our industry needs a lot more to survive.

We understand the magnitude of the pandemic and we are counting on you for ongoing collaboration and support to re-open our businesses and keep them open.

ADMINISTRATIVE OFFICE OCEAN & MISSION• SUITE 201• P.O. BOX 223542 • CARMEL, CA • 93922 PHONE: 831-626-8636 • FAX: 831-626-4269 • EMAIL: [email protected] -2- January25, 2021

Sincerely, C)� 01,,c,1-AW-- Janine M. Chicourrat Chair, Monterey County Hospitality Association

Cc: Monterey County Mayors Monterey County Chambers Monterey County Farm Bureau Growers Shippers Association Senator John Laird Senator Anna Caballero Assemblyman Robert Rivas

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Monterey County Board of Supervisors Via e-mail: [email protected] Subject: COVID-19 Testing and Vaccinations for Agricultural Workers

Dear Chairperson Askew and Members of the Board of Supervisors:

Over the past months it has become clear that our County’s infection rates are the highest among the agricultural workforce and their family members. Monterey County’s move into the next tier depends on us all working together to reduce the spread of the virus across all sectors and especially certain ZIP codes.

Starting in March we can expect another large influx of seasonal farmworkers coming from Yuma, Arizona to help our agricultural industry in Monterey County. According to a recent media report, Yuma has experienced the highest case rate of COVID-19 among agricultural communities.

We, the undersigned Mayors, ask the Monterey County Board of Supervisors to direct the Health Department staff to proactively work with our agricultural industry to provide free testing for all returning farm workers. Only after successful testing has been accomplished, should seasonal workers be allowed to work within our County. Similarly, we strongly support vaccination programs which prioritizes the essential workers employed in the agricultural sector.

We cannot afford to have another surge in Monterey County. What happens in our agricultural sector directly impacts the ability of the Peninsula’s main employers to employ thousands of laid off workers. Our communities and service levels depend on the successful management of seasonal workers in our County. We simply cannot afford to continue being stuck in a tier which restricts or even destroys our economies and with that the livelihood of thousands of residents.

Sincerely,

Dave Potter Alison Kerr Bruce Delgado Clyde Roberson Mayor, City of Mayor Mayor Mayor Carmel-by-the-Sea City of Del Rey Oaks City of Marina City of Monterey

Bill Peake Mary Ann Carbone Kimbley Craig Ian Oglesby Mayor Mayor Mayor Mayor City of Pacific Grove City of Sand City City of Salinas City of Seaside January 29, 2021

Honorable Gavin Newsom Governor, State of California State Capitol Sacramento, CA 95814

Re: Immediate Action Needed to Ensure Equitable COVID-19 Vaccine Distribution for Farmworkers

Dear Governor Newsom:

We thank your administration for rightfully placing farmworkers in Tier 1 of Phase 1B of your statewide vaccination plan. We’re very concerned, though, that such prioritization will be illusory and ineffective without immediate, targeted, statewide action by your administration to effect it. The current, more traditional vaccine distribution channels will not be enough to reach this most vulnerable population, so we implore you to do more—and to do more now. Specifically, we request a robust community-based vaccine outreach campaign. In addition, vaccines should be allocated based on the number of farmworkers in a given region, even if this means distributing directly to cities, neighborhoods, growers, and trusted community-based organizations.

Throughout this pandemic, farmworkers have not stopped working. As you know, farmworkers are disproportionally being infected and dying at higher rates from the novel coronavirus.1 Therefore, while we are grateful that farmworkers were prioritized in Phase 1B, there are several areas where the State is lacking in allocating and distributing the vaccine to these essential workers. Even before COVID-19, farmworkers have been a hard-to-reach population because they live in rural areas, fear government assistance due to their immigration status, face language barriers, and lack access to technology and internet. As such, farmworkers are not receiving vaccine information that is culturally and linguistically accessible.

On top of convincing farmworkers that the vaccine is safe, effective, and available to them, areas with large farmworker populations simply do not have enough doses to distribute. We’ve seen this particularly occur in counties that have opened up vaccine eligibility to seniors of 65 years of age and over during Phase 1B. As a result, farmworkers find themselves having to compete with seniors who more often have the resources, knowledge, and ability to navigate what can be a complex vaccine appointment process. Moreover, a county’s COVID-19 cases may seem moderate as a whole—when it actuality, farmworker communities within that county are being devastated

1 See University of California, San Francisco (UCSF), Excess mortality associated with the COVID-19 pandemic among Californians 18–65 years of age, by occupational sector and occupation (Jan. 22, 2021). by the virus. To address this issue, your administration should allocate vaccine doses on a more localized level driven by need.2 Whether it’s using census tracts, the Healthy Places Index, cities, farmworker advocates, growers, or community-based organizations to allocate and distribute the vaccine,3 this method ensures that there is enough vaccine for the most in-need and at-risk residents. We implore your administration to continue finding innovative ways to make the vaccine widely available by utilizing local pharmacies,4 community centers, work sites, and other familiar settings that farmworkers can easily access.

Farmworkers are the backbone of our state and country’s food chain. This group has historically been underserved and must be a top priority for an equitable vaccine rollout. We trust that your administration will exhaust all resources to educate and engage with farmworkers through trusted messengers, community-based organizations, and employers on the efficacy and safety of the vaccine. Once farmworkers are informed and compelled to receive the vaccine, it is critical that there be enough doses available for them by using the aforementioned equity methods on allocation.

We stand ready to work with you to ensure that equity is at the core of our COVID-19 response in theory and in practice. Thank you for your consideration of these requests and please let us know if you have any questions or need additional information.

Sincerely,

ROBERT RIVAS EDUARDO GARCIA Assemblymember, 30th District Assemblymember, 56th District

2 See attached Letter to Community Vaccine Advisory Committee from the California Rural Legal Assistance Foundation (Jan. 18, 2021). 3 We hear that many growers, such as in Monterey County, are ready and willing to help deploy the vaccine at their grow sites, and have even offered to provide logistical support and pay their workers for their time spent receiving the vaccine. See attached Letter to Governor Newsom from Monterey County Board of Supervisors (“Monterey County is ready with plans, capacity, and partnerships… the County’s plan can be easily scaled as we receive larger amounts of vaccine.”) (Jan. 28, 2021). Farmworker advocates too are mobilized to assist—the United Farm Workers, for example, is collaborating on vaccine deployment with certain growers and Stanford University medical students. See attached Letter to Monterey County Health Officer from UFW Foundation (Jan. 16, 2021). 4 We support the pharmacy deployment pilot program with the California Retailers proposed to you in a Jan. 14 letter led by Senator Caballero, focused on certain highly vulnerable farmworker communities. See attached Letter to Governor Newsom from the California Legislature (Jan 14, 2021). ATTACHMENTS January 18, 2021

Dear Community Vaccine Advisory Committee members:

We are pleased that California’s agricultural workers have been placed, and remain in, Phase 1B, Tier 1 of vaccination distribution. However, recent pronouncements at the federal and State levels are making this prioritization illusory. By elevating age as a priority category and not taking into account occupational, demographic, community and household risk, vaccines will not reach farmworker communities in an expeditious manner.

As we pointed out in our November 2020 policy brief, signed by 11 California farmworker advocacy organizations, farmworkers are an essential workforce at particular risk of COVID-19 due to occupational exposure, their demographics, their lack of access to health services and their local home and community environments. We advocated for a specific strategy to reach the largely immigrant farmworker population which has diminished access to health resources, and a fear of accessing those services that are available.

County implementation plans differ widely, some without taking into account the heightened priority for the food and agricultural workers. No County plans appear to employ an equity metric that would target low-income, high risk agricultural communities. The mass vaccination approach in urban areas for medical workers and seniors, do not account for the smaller remote, rural communities with populations that are not adept at navigating the complex vaccination appointment systems.

As we advocated in our November policy brief, vaccine priorities should include the communities in which farmworkers live. The Healthy Places Index, upon which California relies for its Health Equity Metric, identifies the highest risk communities. Our colleagues have developed an even more robust data tool that identifies census tracts with high numbers of farmworkers from the American Community Survey data. They have already identified high-risk farmworker neighborhoods in Monterey County and Fresno County, and we are happy to share that tool with the Committee and any local health jurisdictions. This tool can help in determining how many doses are needed in each neighborhood or community, the FQHC’s that serve the area and what partnerships with grassroots organizations might be needed to augment vaccination outreach. For vaccine administration to be effective, outreach and education through trusted messengers (e.g. community health promoters, community based organizations and promotoras, community clinics, labor groups, faith-based communities) should begin now, as vaccines are rolled out. To overcome the fears of cost, health consequences, as well as the barriers of language, immigration status and public charge, distance and time, a targeted educational campaign is long overdue.

We appreciate the Committee’s efforts and want to ensure that our agricultural workforce, their communities and families are protected from COVID-19. Our food supply depends on it.

Respectfully submitted,

Noe Paramo Legislative Advocate CRLA Foundation

Cc:

Office of Governor Gavin Newsom California Latino Legislative Caucus California Department of Public Health Farmworker Advocacy Coalition MONTEREY COUNTY

BOARD OF SUPERVISORS

LUIS A. ALEJO, District 1 JOHN M. PHILLIPS, District 2 CHRIS M. LOPEZ, District 3 WENDY ROOT ASKEW, Chair, District 4 MARY ADAMS, Vice Chair, District 5

January 28, 2021

The Honorable Gavin Newsom Governor of California State Capitol Sacramento, CA 95814

RE: COVID-19 Vaccination Requests

Dear Governor Newsom:

Sincerely,

Wendy Root Askew Chair, Board of Supervisors

Edward Moreno, MD, MPH Monterey County Health Officer 1270 Natividad Road Salinas, CA 93906

Dear Dr. Moreno:

As facilitators and messengers trusted by farm workers, we—the United Farm Workers, UFW Foundation and Monterey Mushrooms®—propose collaborating with you in coordinating mobile vaccination efforts that Dr. Walter Newman and Stanford University medical students are prepared to help provide agricultural workers at their job sites. We would start at the large unionized Monterey Mushrooms® facility in Watsonville and then expand the outreach to other farm workers laboring in Santa Cruz, Santa Clara and Monterey counties. Notably, Dr. Newman’s flu vaccination efforts are featured by the Center for Disease Control: https://www.cdc.gov/flu/resource-center/partners/success-stories/success-stanford-flu- crew.htm.

Recently, the California Department of Public Health recommended state and local health authorities prioritize farm workers for COVID-19 vaccinations under the 1B phase, Tier 1 for vaccine distribution, which would put farm workers high on the preference list. While making final distribution decisions you must ensure farm workers remain at the top of the list of those who will get the next round of novel coronavirus vaccines.

Some California county health officials have cited potential challenges in vaccinating farm workers who are often seasonal and transient. Farm workers’ mobility doesn’t mean they can escape the perils of the virus. They regularly live in overcrowded, substandard and unsanitary conditions, commonly in multifamily households. They carpool to work packed into vehicles out of necessity and as a result of how poorly they are paid. Workers frequently toil shoulder to shoulder in fields or packinghouses. Even when social distancing is observed at workplaces, they often can’t avoid sharing close spaces.

Not only should the county follow state guidelines by prioritizing agricultural workers for vaccine distribution, they must also provide factual, scientific information about vaccines in the languages farm workers speak. Farm workers’ insecurities and skepticism over vaccine costs, side effects and disclosure of their personal information must be addressed, especially since at least half are undocumented. Especially effective in delivering this information and these assurances are the UFW, UFW Foundation and employers such as Monterey Mushrooms®. Even before COVID struck, farm workers were among the most vulnerable employees in America. As the nation went into lock down and many Americans sheltered and were able to work at home, farm workers—officially classified as essential by federal, state and local governments—continued going to work. Now, due to multiple effects from the pandemic, farm workers who are overwhelmingly Latino are being disproportionately devastated by the virus, with alarming and growing numbers of infections and deaths.

The threats farm working communities face from COVID-19 are getting worse. Not providing vaccines to vulnerable farm workers due to logistical challenges is unacceptable. In order to help address some of these challenges, we are ready to support the local vaccination administration through a mobile strategy and hope that the county health department will provide vaccines to this collaboration as soon as Phase 1B commences.

Please join us in this crucial collaboration. Thank you for your consideration. We look forward to hearing back from you soon.

Sincerely yours,

Teresa Romero President, United Farm Workers

Diana Tellefson Torres Executive Director, UFW Foundation Member, California Community Vaccination Advisory Committee

Shah Kazemi CEO, Monterey Mushrooms

Dr. Walter Newman Consulting Medical Director, Robert F. Kennedy Medical Plan

Cc: Senator John Laird, District 17 Cc: Assemblymember Mark Stone, District 29 Cc: Assemblymember Robert Rivas, District 30 Cc: Monterey County Supervisor Luis Alejo, District 1 January 14, 2021

Honorable Governor Gavin Newsom State of California State Capitol Sacramento, CA 95814

Re: Vaccinations for farmworkers: Pilot Project

Dear Governor Newsom:

Together, we would plan an inoculation delivery system for each city. As your administration “certifies” other suitable professionals, we can immediately integrate them into this deliver system.

Respectfully,

______Anna M. Caballero Melissa Hurtado Senator, 12th District Senator, 14th District ______Ben Hueso Robert Rivas Senator, 40th District Assemblymember, 30th District

______Jim Frazier Eduardo Garcia Assemblymember, 11th District Assemblymember, 56th District

cc: Tam Ma, Legislative Secretary, Office of Governor Newsom Tomas J. Aragon, Director, Department of Public Health Monica Wagoner, Leg and Gov. Affairs, Department of Public Health Tricia N. Blocher, Deputy Director, Emergency Preparedness Office, CA DPH �FARM BUREAU �L&&/ � 'II!:; MONTEREY �-��;�7 , U'"..,..,....., .. tt'-- s:_g�G MontereyBayAquarium a· cAS.IOCIA11(),'°'JI... � {{-\ Aft ·�...,� ,, � � ,,, , ,,•• 0 o c� RE: COVID-19 Vaccinati n Requests for the Agricultural Sector

Dear Govemor Newsom,

We arc a coalition of Momcrcy County fanncrs, growers, business groups, labor advocates, and hospitality partners who arc deeply concernedabout the dcv3Stating impact that the novel coronavirus has had on the workers in the local agricultural sector. We respectfully request that you work with the CaliforniaDepartment of Public l-lcahh and the Legislature 10 advocate for and procure an additional SS,000 vaccines for the Agricultural community in addition 10 the regular allocation for Monterey County. Wi1h your help. we can facilitate the vaccination of the most vulnerable population and give back to those who have continued to recd our nalion selflessly through heat, rain. fire, and now, a pandemic. In requesting this, we stand unified with our County leadership in their lcncr da1cd January 29. 2021 (attached). reques1ing immediate assistance to suppor11hc Monterey County agricultural communily in gelling vaccinated.

Monlcrcy County (armers and their employees. who have been growing (ood (or Cali(orniaand our na1ion for generations. arc some or the mos1 vulnerable individuals in the Stale. The field and food processing workers and Ag sector have been lcfito mitigate the fiscal and human cos1 of providing our essential services amid the worst hcallh crisis of our time. Within the nexl one to two momhs, up 10 15,000 fonnworkcrs will come rrom Yuma, Arizona and SouthernCalifornia to begin the growing season in Monterey County. (Yuma has had the highest inrcc1ion rate in the nation ofCOVIDI 9 during the pandcmic 1) This influx of fannworkers is in addition to the approximately 40.000 fam1 and food workers who live in Monterey County year-round. TheMonterey County Agricultural community provided statewide leadership in developing protocols for safe business operations during the COVIDI 9 pandemic - including rcs1n1cturing facili1ies, workspaces, transportation, and break areas and developing and communicating safe daily work practices. The Ag scclor established emergency housing for Agricultural workers with COVID19 whoeould not quarantine in late spring 2020, providing a model for the State's Housing/or /-lan•esl program. There ha.s been an e,i:tensivecollaboration between the Ag sector, labor Jmrlners, and worker advocacy groups to increase awareness around COVIOJ9 best prac1iccs and worker rights. Together with conununity panners, the Ag sector came together to distribute food to those in needand promote fast and safecommunity testing.

1 hllps�imcs comJ02.l01.22 JI'- cQrona\jcus-arizona-vuma-co\:Jd.Jllml Despite our best efforts, our region has been dispropor1ionately impacted by lhc effects of COVIDl9. An cs1ima1ed 16,500 fam1workcrshave con1rac1t.-d COVIDJ9. and in Salinas alone. one in five fieldworkers has now fallen ill with COVIDl92• Collectively we arc shocked at the news that 1he La1ino and Black populations arc hair as likely 10 have access 10 the vaccine. especially with lhc understanding that they arc already experiencing death rates from COVIDl9 at threetimes that of the white populationl.

The workers who pick. process. and deliver food lo Califomia families arc mosl al risk. We cannot afford to wait to provide vaccinations to this community. The Monterey County Agricultural sector, which includes organized labor and employers. in partnership with providers like Clinica de Salud and Stanford University Medical School have plans in place to provide vaccinations 10 all agriculture and food workers. along with those 65 and older. Together, we developed a science-based vaccina1ion infom1a1ion campaign to dispel myths, increase vaccination rotes, and help people rcgis1er when vaccinations arc available. Monterey County Heahh Department has the capaci1y 10 s1orc hundreds of thousands of vaccines. The Agricuhural community par1ners arc positioned 10 ensure cquitoble access and. most impor1antly. a swifl. rapid roll-out. None of this can happen without the State's support in providing vaccines explici1ly allocated to our form and food worker workforce of Monterey Counly. We arc asking that you order the procurement of an additional SS.000 vaccines for our agricuhurnl community. With your help, we can focilitatc the vaccination of Monterey Cou111y·s most vulnerable population.

Respectfully. Aaron Johnson. President - Coastal Growers Associalion Christopher Valadez. President - Grower-Shipper Association of Central California Julie Packard. Execulivc Direclor - Monterey Bay Aquarium Cesar Lara, Executive Director - Monterey Bay Cen1rnlLabor Council Bob Roach. Executive Director - Monterey County Cannabis Industry Association Nonn Groot. Executive Director - Monterey Counly Farm Bureau Janine Chicourrat. President -Monterey County llospi1ality Association Kim Stemler. Executive Direclor - Monterey Counly Vintners and Growers Crcscencio Diaz. President - Teamsters Local 890 Pelc Ma1urino. Agricullural Division Dircclor - Unilcd Food and Commercial Workers Local5 Lauro Barajas, Vice President - United Farm Workers Diana Tellefson Torres, Execu1ive Director- Uni1cd Farm Workers Foundation

3 �·\\:.cnn.com.202.l:Oll.21b'l:.oddCQrona1.m1":.nc}'·�lct1cr:Ol:.2.2=2h11uUndcx.h1ml February 4, 2021

Ms. Karen S. Lynch President & CEO CVS Health One CVS Drive Woonsocket, RI 02895

Re: Need for Vaccine Administration Locations in Salinas Valley, in Monterey County

Dear Ms. Lynch:

We are an alliance of prominent Monterey County business organizations, established last year to coordinate and speak as a common voice on coronavirus public health orders and economic relief and recovery proposals. We represent both Monterey Peninsula and Salinas Valley businesses.

Our leadership was disappointed to see that CVS has decided to establish its vaccine administration operations only in the cities of Carmel and Monterey. This decision does not seem to reflect actual conditions for COVID-19 infections and prevalence in Monterey County.

Carmel and Monterey are special places. But these are two Monterey Peninsula cities where an affluent resident population of professionals and retirees with significant educational attainment has generally been able to avoid high risk of COVID-19 infection.

In contrast, much of the population of the Salinas Valley lives in overcrowded housing conditions and finds employment in occupations that require significant interaction with other employees and customers. Despite government, community, and business efforts to minimize the spread of COVID- 19, the infection rate has continually been relatively high in this region.

We understand that market projections may indicate a disproportionately high percentage of residents on the Monterey Peninsula will be eager and willing to receive vaccinations. However, our organizations are working to ensure that Salinas Valley residents also take advantage of opportunities for vaccinations.

The County of Monterey is working with the Community Foundation for Monterey County and other organizations through a $5 million county-funded program to encourage vaccinations in communities where there is greater distrust of government authorities and public health edicts. CVS can help this effort, and in our efforts to meet the Equity Matrix required by the State of California, with at least one vaccine administration site in the Salinas Valley.

Sincerely,

Monterey County Business Alliance (which includes the following signatory organizations) Frank Geisler, President & CEO Paul Farmer, President & CEO Monterey Peninsula Chamber of Commerce Salinas Valley Chamber of Commerce

Andria Brinson, President Janet Bessemer, Manager Soledad Mission Chamber of Commerce King City Chamber of Commerce

Elizabeth Vitarisi Suro, Managing Director Jenny MacMurdo, President & CEO Carmel Valley Chamber of Commerce Carmel Chamber of Commerce

Moe Ammar, President Kirk Gafill, President Pacific Grove Chamber of Commerce Big Sur Chamber of Commerce February 9, 2021

Governor Gavin Newsom 1303 10th Street, Suite 1173 Sacramento, CA 95814

Dear Governor Newsom,

We commend your decision to prioritize food and farm workers in the State of California’s Phase 1B distribution plan for the COVID-19 vaccine. As you continue leading the state’s vaccination efforts, we write to request that vaccine distribution is equitable for all full-time and part-time residents and that there is a robust educational campaign for these essential workers to feel secure in seeking out and accepting the vaccine.

California’s 800,000 agricultural workers are an essential workforce responsible for sustaining California’s $50 billion agricultural industry and the production of America’s fresh food supply.1 Employment in California agriculture is highly cyclical, with more than 254,000 migrant, seasonal, or migrant food-processing workers traversing the state each year.2 At the county level, the seasonal workforce may double during harvest, however on an individual farm, the harvest to winter worker ratio may be as high as 100 to 1.3 Due to the unique composition of the communities in our districts, we encourage a farmworker-specific component in any vaccination plan that rises to the challenges of enumerating our migrant agricultural workforce to ensure they are accounted for.

We applaud the steps you have taken to partner with Blue Shield of California and the Federal Emergency Management Agency (FEMA) to expand the efficient and equitable distribution of vaccines across the state. We also commend your role in advising the private partners of the Federal Retail Pharmacy Program for COVID-19, including CVS and Walgreens, on the unique needs of our great state. We will continue to advocate at the federal level for an increase in vaccine doses being sent out to states. As you continue the important task of making decisions and advising on the equitable distribution of vaccines and mobile clinics to counties, we urge you to include our migrant food and farm workers in your allocation plans.

1 https://www.cdfa.ca.gov/statistics/ 2https://www.edd.ca.gov/jobs_and_training/migrant_and_seasonal_farm_worker_outreach_program.htm#:~:text=Th e%20Migrant%20and%20Seasonal%20Farmworker,including%20more%20than%20254%2C000%20MSFWs. 3 https://www.jstor.org/stable/26758669?seq=1. Over the past several months, we worked across the aisle to secure substantial funding in H.R. 133 for agricultural worker safety. Since that bill was signed into law in late December 2020, we have been advocating for at least $1 billion in U.S. Department of Agriculture (USDA) funds for COVID-19 mitigations in agricultural communities. As we continue to work in a bipartisan fashion to ensure USDA prioritizes agricultural worker safety, we look to you to take steps to conduct both linguistically accessible and culturally appropriate outreach to agricultural communities that have suffered disproportionately from this virus.

While agricultural communities have worked to provide personal protective equipment and take measures to safeguard employees, farmworkers have accounted for a disproportionate share of COVID-19 cases since the onset of the pandemic. Recently, a University of California, Berkeley white paper (published December 2, 2020), detailed the outcomes from the first long-term study on the prevalence of, and the risk factors for, COVID-19 infection among California’s agricultural laborers.4 From mid-July to November 2020, 13% of the 1,091 farmworkers enrolled in the study tested positive for COVID-19. This is 8% higher than California’s population as a whole. Further, antibody results from farmworkers who tested negative for active infection revealed that antibody was 19.4% by October.

The need for rapid vaccination in these communities is clear. However, we are concerned that, due to previous harmful rhetoric and efforts to create distrust in immigrant communities, there may be added challenges when it comes to ensuring our food and farm workers have the information they need to access vaccine distribution sites and feel safe taking the vaccine.

Unfortunately, with dangerous new strains emerging around the world, the COVID-19 pandemic is far from over. The coming weeks will be critical to curb the spread of this virus and we must work together to keep our promises to the agricultural communities in California who have shown up to do their jobs and put food on our tables. We look forward to partnering with you on these efforts.

Sincerely,

______Jimmy Panetta Jim Costa Member of Congress Member of Congress

4 UCB CSVS white_paper 12_01_20_final (berkeley.edu) ______Mike Thompson John Garamendi Member of Congress Member of Congress

______Josh Harder Salud Carbajal Member of Congress Member of Congress

______Juan Vargas Nanette Diaz Barragán Member of Congress Member of Congress

______J. Luis Correa Member of Congress Monterey County Office of Education Leadership, Support, and Service to Prepare All Students for Success

Dr. Deneen Guss County Superintendent of Schools

February 10, 2021

The Honorable Gavin Newsom Governor of California 1303 10th Street, Suite 1173 Sacramento, CA 95814

Dear Governor Newsom,

We are writing today to thank you for your support of schools by prioritizing education and childcare workers in Phase 1B of the state's COVID-19 vaccination distribution plan and ask for your commitment to returning to in-person instruction for all students and staff as safely and quickly as possible.

In Monterey County, 34.3% of our students are English Learners, 9.9% are Homeless, 10.9% are Students with Disabilities and over 75% of our students are also Socioeconomically Disadvantaged. These numbers are exponentially higher in some of our communities hardest hit by COVID-19. Our students need in-person instruction. Vaccines for education and childcare employees are a top priority: We have all been working on school reopening plans that include implementing multiple layers of protective measures such as physical distancing, cleaning and disinfecting, surveillance testing, minimizing mixing of groups, and use of personal protective equipment (PPE). However, vaccination remains a critical component in order to meet our collective goal to serve and support all students in person as soon as possible.

Monterey County estimates over 200,000 residents fall into Phase 1B, Tier 2 - including those in education and childcare, agriculture and food, and first responders. At the current rate our county is receiving vaccines, it will take a year or more to vaccinate those within this tier. This is unacceptable. Our frontline residents, especially those serving students in-person in classrooms and small learning cohorts, deserve to be vaccinated as soon as possible.

While we recognize California does not control the vaccine supply and distribution, the state is responsible for a coordinated statewide approach. Keeping vaccination of education and childcare workers a top priority will accelerate in-person instruction for our students, a critical component in addressing inequities and learning recovery, and supporting the significant mental wellness needs that are best served in-person. Our schools provide a safe place where children get meals and other necessary support services that are not available elsewhere due to COVID-19.

We are ready to partner with the State of California and any healthcare providers, and will continue to work alongside Monterey County Health Department in the efforts to vaccinate education and childcare staff in this next tier, following those age 65 and over. We offer our assistance in providing venues for vaccination and personnel to support the vaccinations of this critical group of public servants.

Our county is also unique in that we have never left the Purple Tier of the Blueprint to a Safer Economy. Only 13 of our schools received waivers and were able to re-open prior to the change in guidance in January 2021. Only five of those schools are public schools. We all strive for equity and the opportunity to provide in-person instruction for all students, across all socioeconomic backgrounds. It is difficult to justify how students in one area of our county, in some cases next door to districts offering in-person instruction, are not afforded the benefit of in-person instruction. We realize opening schools for in-person instruction may take different paths; each of our districts and communities are unique in their

901 Blanco Circle Post Office Box 80851 Salinas, California 93912 www.montereycoe.org Salinas: 831.755.0300 Monterey: 831.373.2955 Fax: 831.755.6473 needs and in the resources they have available to them. Providing structures that enable them to open for in-person instruction should be of the utmost priority.

Sincerely,

Dr. Deneen Guss, Monterey County Superintendent of Schools

In partnership with all Monterey County School District Superintendents and Charter School Directors: Jim Koenig, Alisal Union School District Debbie Gold, Big Sur Unified School District Lindsay Lopez, Bradley Union School District Trisha Dellis, Carmel Unified School District Roberto Rios, Chualar Union School District Yvette Irving, Gonzales Unified School District Rosemarie Grounds, Graves School District Zandra Jo Galvan, Greenfield Union School District Rory Livingston, King City Union School District Daniel Stonebloom, Lagunita School District Dr. Jinane Annous, Mission Union School District Dr. PK Diffenbaugh, Monterey Peninsula Unified School District Kari Yeater, North Monterey County Unified School District Dr. Ralph Gómez Porras, Pacific Grove Unified School District Dr. Rebeca Andrade, Salinas City Elementary School District Dan Burns, Salinas Union High School District Josh Van Norman, San Antonio Union School District Dr. Catherine Reimer, San Ardo Union School District Jessica Riley, San Lucas Union School District Tim Ryan, Santa Rita Union School District Randy Bangs, Soledad Unified School District Dr. Brian Walker, South Monterey County Joint Union High School District Eric Tarallo, Spreckels Union School District Gina Uccelli, Washington Union School District Karina Barger, Bay View Academy Aimee Alling, Big Sur Charter School Sean Madden, International School of Monterey Kenneth Lawrence-Emanuel, Learning for Life Charter School Cassandra Bridge, Monterey Bay Charter School Justin McCollum, Monterey County Home County Charter School cc: Wendy Root Askew, Chair, Monterey County Board of Supervisors Elsa Jimenez, Director, Monterey County Health Department Robert Rivas, California State Assemblymember Anna Caballero, California State Senator February 12, 2021

Governor Gavin Newsom State Capitol Sacramento, CA 95814

Via email

Dear Governor Newsom:

We write to you on an issue of utmost urgency related to COVID-19 vaccinations within our community. Nearly 35,000 seasonal farmworkers will be traveling to Monterey County in a matter of weeks to begin work on the spring harvest and it is not clear the state is properly planning for their arrival, care, or vaccination. These farmworkers will be traveling mostly from Yuma, Arizona – a known COVID-19 hotspot. The Monterey County Board of Supervisors and Monterey County’s health director have all written your office and the California Department of Public Health on this issue, however they have not gotten a response.

What is unclear is how the state is working to address the vaccinations needed to protect this vulnerable and valuable workforce. The data is clear; Latinos in our state are disproportionately impacted by COVID-19 infections, bearing the brunt of infections, hospitalizations, and deaths. Farmworkers up and down the state, including those within our community, are working selflessly through this pandemic to put food on our tables and support their families. They put their lives on the line everyday they go to work, rain or shine, clear or smoke-filled skies, so we can eat. We owe this key part of our workforce and community a workable plan to ensure their health and safety.

Since this is a seasonal workforce, they are not included in the County’s overall population. This unfairly and unjustly skews vaccine allocations. With cramped housing conditions and communal transportation as the only option for travel, this is a recipe for a health and economic disaster. There needs to be a comprehensive plan to ensure their arrival, which our economy benefits from, is considered when allocating vaccines to our already sparse allocations.

We have attached the correspondence from the County to provide additional background on this issue. In addition, we are happy to convene meetings with all involved to ensure this pressing matter is addressed quickly. Please contact Richard Stapler on Sen. Laird’s staff at 916 549 9630 to schedule meetings or get additional information.

Thank you,

State Senator John Laird (D-Santa Cruz)

State Senator Anna Caballero (D-Salinas)

State Assembly Member Robert Rivas (D-Hollister) March 4, 2020

The Honorable Gavin Newsom Governor of the State of California State Capitol Sacramento, California 95814

Re: FEMA supported vaccine centers in Monterey County

Dear Gov. Newsom:

We respectfully write to ask that you use your Executive authority as Governor of our state to request additional Federal Emergency Management Agency (FEMA) Federally Supported Vaccine Centers to improve the equitable distribution of vaccinations for essential workers in rural and hard to reach areas of California. We are working with Congressman Jimmy Panetta to bring a critically needed Type 5 Mobile Vaccination Center to the Salinas Valley in order to quickly vaccinate essential workers that are critical to agricultural production.

The Salinas Valley produces over 150 specialty crops and exports nearly 400 billion pounds of produce every year. Increased vaccination efforts to support this critical industry are needed as Monterey County expects to see the return of 35,000 seasonal agricultural workers that will increase the total agricultural workforce to over 60,000 people. Increased doses have reached Monterey County, but it is imperative that we work to expedite this process to safeguard workers and maintain our region’s ability to provide the freshest produce for our nation.

Strong efforts are being made locally to continue farming even while facing unprecedented challenges created by the pandemic. These efforts have led to the creation of a strong collaborative infrastructure that can organize vaccine distributions quickly and would be aided by having additional vaccine support in our region. A Type 5 Mobile Vaccination Center would be ideal to create vaccination sites that more efficiently serve a workforce spread out along the Salinas Valley.

Thank you for considering this action. We stand at the ready to assist you in any way possible. Sincerely,

Anna M. Caballero, Senate District 12 John Laird, Senate District 17

Robert Rivas, Assembly District 30

Cc: Angie Wei, Office of Governor Newsom Dr. Tomas Aragon, Department of Public Health