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California is preparing to close dozens of state-run COVID-19 testing and treatment sites ahead of the planned end of the state of emergency in February.
Sites that are operating under 50% capacity are scheduled to close before the end of January. Forty-four OptumServe sites will be shuttered this week, and 48 mobile "mini-buses" will begin closing in two weeks, according to the California Department of Public Health. OptumServe, a health care operations company, runs 123 testing and treatment sites along with four vaccination clinics through state contracts.
The health care giant has at least four contracts, under its former name Logistics Health, with the state totalling $1.05 billion to provide testing and vaccination services though it has been criticized in the past for its bumpy rollout. Another branch of the company signed an additional $47 million contract to design a data management system for COVID-19 test results.
"A final plan for demobilizing the remaining sites is being prepared, but we have not set a completion date," an unidentified department spokesperson said in a statement. The state health department would only answer emailed questions and did not attribute the statement to a person.
The state of emergency, which has provided extra funding and staffing flexibilities at medical facilities, is slated to end on the last day of February.
The closures come just one week after Gov. Gavin Newsom released his January budget proposal, which moves $614 million in unspent COVID-19 response funds to the state's general fund and drastically reduced the amount of pandemic money for the upcoming year.
Last year's budget included $1.8 billion for COVID-19 emergency response and the state's long-term strategy, while the proposed budget for the upcoming fiscal year is only $176.6 million. The cutbacks come as the state faces a projected $22.5 billion deficit, according to Newsom's proposal. State Health and Human Services Secretary Dr. Mark Ghaly said in a budget call with reporters that the bulk of the proposed decrease comes from fewer state testing responsibilities, but he emphasized that the spending reductions are not "a statement about moving on from COVID in California."
"We will continue to seek opportunities to support public health," Ghaly said. "We learned a lot through this COVID response, and we need to make sure we don't lose those gains."
Demand for molecular COVID-19 testing has plummeted statewide since last January, when the omicron variant pushed hospitals to the brink of collapse. At the time, more than 800,000 PCR test results were reported for a single day and more than 15,000 people were hospitalized with COVID-19 at the peak of the surge. In comparison, less than 30,000 test results and 4,600 hospitalizations were reported on the final day of December (the most recent day with finalized tallies, according to state data).
Across the state, county health departments are preparing for the closures and absorbing the costs into their own budgets.
In Los Angeles County, OptumServe will stop operating four sites, but the county will contract with another vendor to keep the doors open, a county health services spokesperson said via email.
"It is important to underscore that the change will be seamless," the health services communications office told CalMatters in an unsigned statement. "Community residents seeking a testing site will not experience any disruption to the existing services."
During a media briefing last week, L.A. County Public Health Director Barbara Ferrer said the county was committed to ensuring there are "ample" testing and vaccination options.
In other areas of the state, health departments are unable to run the sites alone. All five OptumServe sites in Fresno County will close by Jan. 31. Only one of the sites is currently operating above 50% capacity, public health spokesperson Michelle Rivera said. The mobile test-to-treat buses will stop services the first week of February.
Community members will still have options, Rivera said. The county health department is continuing to work with community-based organizations, UCSF-Fresno and Fresno State's nursing school to keep offering testing, treatment and vaccination services throughout the area. The Fresno County Board of Supervisors also approved funding for a rural mobile health program to deliver health care to farmworker and other rural communities.
Fresno County has been hit particularly hard by the latest post-holiday wave of COVID-19 as well as concurrent flu and respiratory syncytial virus surges, issuing emergency do-not-transport orders to EMTs for the sixth time since the start of the pandemic to combat overflowing emergency departments. Do-not-transport orders, also known as assess-and-refer, require ambulance personnel to determine whether a patient requires emergency transportation or if they are stable enough to be referred to a non-emergency medical facility like primary care.
In Santa Clara County, state-run sites are also slated for closure in the coming weeks, emergency operations spokesperson Roger Ross said. The county will, however, continue to run three mass vaccination sites and has already begun folding COVID-19 response into the health department's normal operations.
"Public health recently created a COVID Prevention and Control Program as part of our standard operations. Most of the work now resides here," Ross said. "Unfortunately, it appears we will be dealing with COVID for the long haul."
In Orange County, where COVID-19 health orders have at times drawn public ire, testing and vaccination strategies will largely move to "the open marketplace where individuals will self-manage COVID-19" through primary care and other community resources, the health department announced last month in a news release. County-run vaccine sites, which were serving about 200 patients per week, were closed in December, although the health department continues to offer vaccinations for vulnerable populations like unhoused individuals, said Obinna Oleribe, deputy chief of Orange County public health services.
The federal government requires health insurance plans to cover eight over-the-counter COVID-19 tests per person per month, including FDA-approved at-home PCR tests. Every household can also order four free rapid tests from the federal government. When used appropriately, at-home tests of all kinds are considered highly accurate, although data shows PCR tests are more reliable.