HEALTH
Drug Program Cuts Threaten COVID Vaccine Effort
Health offi cials say looming 340B reductions imperil outreach, education, staffi ng
BY TAT BELLAMY-WALKER
As New York begins
COVID-19 vaccinations,
health offi cials
say looming cuts to
the states’s 340B drug discount
program could make it even more
challenging to vaccinate the city’s
most vulnerable populations.
Under the 340B program, managed
Medicaid providers receive
discounted drugs for underserved
clients. COVID-19 outreach is
among the many types of services
funded under this program. Offi -
cials told Gay City News that outreach
is a costly yet effective part
of slowing the spread of the virus.
But, looming state budget cuts
slated for next spring could threaten
these services.
In the past, non-profi ts were
able to apply the difference between
the discounted drug price
and the Medicaid reimbursement
they received to carry out other
services. But under the planned
cuts, that amount, estimated at
roughly $250 million annually,
would be diverted back to the
state under a fee-for-service model.
Governor Andrew Cuomo’s
plan to offset a portion of the reduced
funding by providing an
additional $100 million to such
healthcare providers is widely
viewed as “just giving with one
hand while you take much more
with the other,” in the words of
Patrick McGovern, chief business
development and policy offi cer
at Amida Care, a not-for-profi t
health plan serving people living
with HIV/AIDS.
Charles King, the CEO of Housing
Works, a non-profi t focused on
HIV/ AIDs and homelessness, said
the 340B funding is necessary in
dispelling misinformation about
the COVID-19 vaccine and vaccines
in general.
“If we had to spend 20 minutes
walking them through why the
vaccines important and why it’s
safe, we wouldn’t be able to afford
to take that time,” King said. “It
would really undermine our efforts
to ensure the people we serve get
Anthony Fortenberry, director of nursing at the Callen-Lorde Community Health Center, warned that
340B cuts could reduce that group’s ability to maintain the nursing staff necessary to carry out an
effective vaccine effort.
Governor Andrew Cuomo in Albany on December 3.
vaccinated.”
Developing trusting relationships,
he said, is critical for followups
and helping patients stick with
treatment.
“If you’re serving a population
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that is suspicious of the healthcare
system, doesn’t have a lot of education
around healthcare issues,
and particularly has reason to be
suspicious about drugs, you’ve got
to take the time to work with people,
to listen to them, to encourage
them, to hear them out,” King
said.
Years of discrimination from
doctors make it even more diffi cult
for marginalized people, including
people of color and LGBTQ communities,
to trust the medical system.
A recent study from the Pew
Research Center found that while
Black Americans are more likely
to know someone who has died as
a result of COVID-19, they’re still
less likely to seek a vaccination
when compared to other ethnic
groups.
Another study published last
month from the Community Health
Care Association of New York State
shows clinicians are reporting
similar concerns.
“We know that a lot of the staff
at health centers have a lot of questions.
And this is because the vaccine
is so new,” said Rose Duhan,
the organization’s CEO. “There’s
reimbursement for administering
the vaccine, but there’s not reimbursement
for the clinicians’ time
to be spent in conversations…
amongst the other clinicians or
with the staff.”
But, it’s not just outreach and
education that’s at stake. Anthony
Fortenberry, the director of nursing
at the Callen-Lorde Community
Health Center, which specializes
in LGBTQ-focused care, said staffing
is also at risk.
“Our nurses are funded through
340B dollars,” Fortenberry said.
“The lack of 340B funding would
mean that we would not be able to
have the amount of nurses that we
would need to be able to meet community
demand.”
Slashing these resources from
health centers is “bad policy” and
“bad timing,” said Amida Care’s
McGovern.
“When the state is determined to
try to overcome resistance within
communities of color to take these
vaccines and then trying to fi gure
out how to distribute vaccines in
an unprecedented scale,” he said.
“You need to rely upon these very
institutions that you’re draining
all of this support from.”
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