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Beam under fire by state lawmakers

Appropriations committee grills acting Health Secretary on admissions, vaccine

The state House Appropriations Committee on Thursday grilled acting Health Secretary Alison Beam on the Wolf administration’s requirement early in the pandemic that nursing homes accept COVID-19 readmissions from hospitals and the administration’s recent massive expansion of the top-priority vaccination group, leading to frustration among people who can’t get appointments for shots.

Committee members said those readmissions allegedly added to the homes’ devastating death counts, and both decisions appear to be blunders.

In both cases, the administration was following federal guidance, Beam said.

Pennsylvania’s 12,000 deaths in long-term care facilities is third-most in the country and more than in California, Texas and Florida, which have bigger populations, said state Rep. Natalie Mihalek, R-Allegheny.

“This order contributed to it,” Mihalek said. “Was that order then a mistake?”

The administration worked with the federal government to clarify guidance on the matter for homes in Pennsylvania, Beam said.

The Pennsylvania approach was stricter, Mihalek said.

Clearer — but not different, according to Beam and Keara Klinepeter, executive deputy secretary at the Department of Health.

State, federal guidance

Nursing homes “can accept” residents with COVID-19, provided they follow precautions, the federal guidance stated.

Homes “must continue to accept” new admissions and readmissions of stable patients from hospitals — and those “may include stable patients who have had the COVID-19 virus,” the Pennsylvania order stated.

The administration crafted that order with the encouragement of the federal government, so facilities in Pennsylvania, which were challenged by COVID-19 then, unlike facilities in some states, understood better what needed to be done, Klinepeter said.

It was done to protect hospitals here from being “overrun,” as hospitals in other countries had been overrun, Beam said.

But was it a mistake? Mihalek reiterated.

Long-term care facilities were “trying to find a path forward: it was very confusing. …” Beam said.

Mihalek interrupted.

“Thank you, ma’am. I appreciate your loyalty to the order,” she said. “I would not want to be the one to look into the eyes of those loved ones of these 12,000.”

Declining to answer the question “makes it clear it was a mistake,” said Committee Chairman Stan Saylor, R-York. “I don’t know why when you make mistakes, you can’t agree a mistake was made.”

Expand vaccinations

The department’s decision on Jan. 19 to expand vaccination Phase 1a to 4 million people — adding to a category that originally comprised health workers and long-term care residents and staff everyone 65 and older and everyone 16 to 64 with qualifying health conditions — created expectations that were impossible to fulfill, given the limited supply of vaccine, said state Rep. Meghan Schroeder, R-Bucks.

“We followed the federal guidance very closely” on that issue, Beam said, “as we had done previously with (vaccination) phases.”

“Someone in your department made that decision without thinking ahead,” Schroeder said, saying the department, not the federal government, was ultimately responsible for it. It didn’t make “common sense,” she added.

Lawmakers also challenged Beam about other alleged shortcomings in the administration’s pandemic response.

Gov. Tom Wolf’s recent claim in a news conference that vaccinations are finished in nursing homes is incorrect, lawmakers said.

While vaccinations are essentially done in 650 nursing homes that participated in a federal pharmacy vaccination partnership, there are 50 additional homes that opted out of the partnership due to their relationships with local pharmacies, and the department continues to work with them to ensure everyone is vaccinated, Beam said.

The administration is vaccinating inmates in two Department of Corrections facilities that handle older inmates, even as corrections officers, teachers and long-term care residents in the general population remain unvaccinated, one lawmaker complained, adding that the inmates in those two facilities have had very low infection rates.

Those facilities may be run by the DoC, but they are nursing homes, and their residents are in the category for priority vaccinations, Beam said.

What about hospital systems that have vaccinated all employees, including billing clerks and fundraisers who never encounter COVID-19 patients, one lawmaker wondered.

The administration is looking to make providers more accountable, Beam replied — not answering the question directly.

UPMC has been vaccinating all its employees, arguing that all types of them are necessary to run its system, which — overall, is a critical part of the COVID-19 response, UPMC officials have said.

Failure to plan?

The Wolf administration’s difficulties with the vaccination rollout reflect a failure to plan, given that it was clear a year ago that vaccinations would be the key to quelling the pandemic, one lawmaker said.

The difficulties highlight the administration’s refusal to accept the General Assembly’s offer in March to participate in a joint task force, the lawmaker said.

The difficulties also highlight the potential benefits of a central registration system, the lawmaker said.

“We are not shying away from a conversation around a central registry” — although there are questions about how practical it might be at this point, Beam said.

“We’re hitting you pretty hard,” Saylor said at the end.

But so are the lawmakers — by their constituents, he said.

Beam, who took over in mid-January from Rachel Levine, now working for the administration of President Joe Biden, has an “impossible job” — given “unrealistic” expectations from so many, said Rep. Matthew Bradford, D-Montgomery.

Impossible job or not, “We’ve got to double down for the next few months,” Bradford said.

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