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N.H. Vaccination Push Slowed In Wake Of Disruptive Protest At Executive Council Meeting

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The contracts at the center of the unruly protests that shut down an Executive Council meeting Wednesday would bring more federal money to the state to significantly expand COVID-19 vaccination efforts. With those contracts now effectively stalled, state health officials say an urgent need to boost vaccine outreach is in limbo.

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The protesters who disrupted the Council meeting were driven by opposition to a plan, tied to $27 million in federal funding, that would create 13 temporary positions at the Department of Health and Human Services for immunization work.

The contracts had already been tabled at the Executive Council meeting on Sept. 15, and put on hold by the Legislature’s Fiscal Committee earlier this month. Both bodies need to approve the contracts for the money to come to the state.

The Fiscal Committee was supposed to revisit the funding on Friday, but that meeting has also been postponed in the wake of Wednesday’s raucous protests, at which some state officials who were present said they feared for their safety because of what they considered threatening behavior from protesters. The New Hampshire Department of Justice is reviewing whether protesters’ behavior broke any laws.

“Urgent” Needs Now On Hold, State Says

The scope of the two contracts that drew protesters’ attention include vaccine outreach, assistance for healthcare providers navigating the logistics of vaccines, and support for data entry. The contracts also include money for computer software and other expenses like vaccine shipping supplies and office supplies for staff.

In its request for funding, the state health department called filling these positions “urgent,” and that they would increase “the state's capacity to implement effective immunization programs to prevent the occurrence of deadly infectious diseases, including COVID-19.” A spokesperson for the department says the hiring for the 13 positions is now on hold.

New Hampshire’s COVID-19 vaccination rate has plateaued over the past several months, essentially unmoved since July.

Two additional contracts with private companies to expand vaccination efforts were also on the table at Wednesday’s cancelled council meeting, and are likewise on hold. With booster shots now available for some of the population, and expected for more Granite Staters in the coming months, the state was planning to expand a contract with a company called On-Site Medical Services. The company previously operated one vaccination site in Newport, and runs a small mobile team. The proposed funding, which would bring the contract to $15.6 million, would pay On-Site to administer homebound vaccinations and hold mobile clinics.

On-Site’s president, Jim Keady, said he had already hired nurses for the homebound program, planning to have them start on Monday.

”First thing I had to do was call up the employees we’d pre-hired, and let them know there was going to be a delay,” he said.

Keady said the nurses were understanding and willing to forgo a paycheck for the next two weeks. But the booster shot effort he’d been planning to staff could delay a shot for some residents, with many of those On-Site planned to reach through the homebound effort unable to travel to a local pharmacy for a booster shot.

Dr. Beth Daly, chief of the state’s Bureau of Infectious Disease Control, said part of the system in place for the homebound booster effort was the contract with On-Site. She said she hopes “when it does get reviewed at the next Governor and Council meeting that the contract will go into place and we will be able to roll out that program.”

Keady is currently planning to go forward with mobile clinics he had scheduled, despite the pause in funding, and said he’s meeting with state officials Friday to discuss plans.

Gov. Chris Sununu has reiterated in recent weeks that future vaccine administration will be led by the private healthcare sector, rather than state government. In an interview with NHPR earlier this month Sununu said the state should not be in the position of being “the booster guys” or having to “call the National Guard out every year.”

But, he said, if needed the state could provide a stopgap solution. A part of that solution is the contract with On-Site, which includes funding to launch up to five additional vaccination sites on three weeks' notice, if the state decides they're needed.

Additional funding for the state’s mobile vaccine van, and the launch of a second van, was also on yesterday’s agenda. That money is also on hold in the wake of the protests.

Claims of Overreach

Many of Wednesday’s protesters focused on a standard section in the contract which they claimed would increase federal control and oversight of New Hampshire’s public health efforts. Experts, however, say that’s not the case.

The section states that recipients of the grant, which comes from Coronavirus Disease 2019 (COVID-19) Funds, agrees, as applicable to the award, to, among other things “comply with existing and/or future directives and guidance from the Secretary regarding control of the spread of COVID-19” and “assist the United States Government in the implementation and enforcement of federal orders related to quarantine and isolation.”

This exact language exists in numerous contracts the state has already approved for other federal COVID-19 related funding. For instance, a $22.6 million contract also created temporary positions to support the mitigation of COVID-19, including a community engagement specialist. A spokesperson for the New Hampshire Department of Health and Human Services said the acceptance of this prior funding did not change the department's relationship with the CDC regarding any public health measures.

The state currently does not mandate CDC’s recommendations like masking in all public schools or indoor mask wearing in areas of substantial or high transmission rates.

A Facebook post from RebuildNH, one of the groups helping organize COVID-related protests in the state, claimed, with no evidence, “if we take the funds and the Secretary says we have to enact a door to door vaccine push, we have to. If the Secretary says the unvaccinated need to be put in ‘quarantine’ camps, we have to.”

At a press conference Thursday, Sununu tried to dispel some of the misinformation about these contracts that he said was “swirling around on social media.” Sununu said it “has never been the case” that accepting COVID funds would mean giving up sovereignty as a state.

“None of the language prohibits the state from managing the processes in our own way,” he said.

Sununu did call the language “incredibly vague,” and said the executive councilors asked for the attorney general’s input to ensure that New Hampshire can still manage these funds with minimal federal interference.

Nick Toumpas, former commissioner of the New Hampshire Department of Health and Human Services, said that nothing in the contract under dispute would ask the state to do something different to the approach it is currently taking to fight the pandemic.

Federal funds are a huge part of the health department's budget, helping fund everything from Medicaid to behavioral health services, Toumpas noted. And that money, Toumpas says, always comes with some requirements.

But working with the federal government on public health measures isn’t new. Laws between the federal government and all states regarding quarantine and other public health measures are long standing, said a spokesperson for the Department of Health and Human Services. For example, during the ebola outbreak, the state health department worked closely with the federal government.

Andy Baker-White, senior director of state health policy at the Association of State and Territorial Health Officials, said the clauses protesters pointed to “set out what states and the federal government have been doing; not just in this pandemic, but in other public health issues."